Perry B Kubek, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS010636L Issued in PA

Practice address

5970 Lemon St
East Petersburg, PA 17520-1316

Phone

(717) 569-7011

Fax

(717) 569-8694

NPI assigned

Sep 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkubekdo2393@direct-lghealth.org

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.

• Lancaster General Medical Group

  • Psychiatry Physician
  • Lancaster, PA
  • NPI 1952392383
  Medicare reassignment NPD
• Lancaster General Medical Group

  • Family Medicine Physician
  • Lancaster, PA
  • NPI 1023003647
  NPD
• Lancaster General Medical Group

  • Obstetrics & Gynecology Physician
  • Lancaster, PA
  • NPI 1306724570
  NPD

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258329600000",
    "number": "1669468583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 MAIN ST",
            "city": "EAST PETERSBURG",
            "state": "PA",
            "postal_code": "175201513",
            "telephone_number": "717-569-7011",
            "fax_number": "717-569-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5970 LEMON ST",
            "city": "EAST PETERSBURG",
            "state": "PA",
            "postal_code": "175201316",
            "telephone_number": "717-569-7011",
            "fax_number": "717-569-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBEK",
        "first_name": "PERRY",
        "middle_name": "B",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2009-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS010636L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "71741 S1QC",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "561080",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1130425",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO",
            "identifier": "7291120",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ASSURANCE",
            "identifier": "H14465",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "P002562",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017934970003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50014740",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glinda Johnson Medland, LCSW
• Kevin William Kelly, PSY.D.
• Kyle Michale Kennedy, LCSW
• Rebecca King, LSW
• Tammy Lucas King, PSYD
• Mary Lou Kunkle, LPC
• Timothy J Labosh, M.D.
• Lancaster General Medical Group
• Lancaster General Medical Group
• Lancaster-Lebanon Intermediate Unit

• Family Medicine Physician in East Petersburg, PA
• Providers in East Petersburg, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.