Individual provider Active NPI

Marcus Kuboy, MSW, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1669339057
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24709 Issued in MN
Practice address
2550 University Ave W Ste 435S
Saint Paul, MN 55114-1907
Phone
(651) 647-1900
Fax
(651) 342-8023
NPI assigned
Jan 7, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 24709 MN Primary

Addresses

Primary practice location

2550 University Ave W Ste 435S
Saint Paul, MN 55114-1907

Mailing address

2550 University Ave W Ste 435S
Saint Paul, MN 55114-1907
Phone (651) 647-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260325000455 MN Practitioner - Clinical Social Worker 4385128685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2250 University Ave W
Suite 435S
Saint Paul, MN 55114-1801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24709MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Center for Personal & Family Development PA Past Accepting new patients
Pathway Virtu-Health Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1767744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1669339057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W STE 435S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141907",
            "telephone_number": "651-647-1900",
            "fax_number": "651-342-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W STE 435S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141907",
            "telephone_number": "651-647-1900",
            "fax_number": "651-342-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBOY",
        "first_name": "MARCUS",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.