Individual provider Active NPI

Cecily Alexandra Dubaj, NP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1699292292
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9336228 Issued in FL
Practice address
75 Varick St
New York, NY 10013-1917
Phone
(855) 672-2755
NPI assigned
Aug 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5010575 NC
Family Nurse Practitioner 363LF0000X 9336228 FL Primary

Addresses

Primary practice location

75 Varick St
New York, NY 10013-1917

Mailing address

75 Varick St
New York, NY 10013-1917

Other practice location 1

11925 Lakemist Cir
Temple Terrace, FL 33617-1786
Phone (813) 494-4584

Other practice location 2

190 Riverview St
Franklin, NC 28734
Phone (828) 349-6804

Other names 1

  • Cecily Alexandra Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180207000191 FL Practitioner - Nurse Practitioner 3779843099 Reassigns benefits to 4 organizations
I20260617001235 IN Practitioner - Nurse Practitioner 3779843099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Florida College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians

Practice addresses (Care Compare)

2350 Taft St
Gary, IN 46404-3349
Phone (877) 883-9430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5010575NCMDNurse Practitioner
9336228FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neuspine Institute LLC CurrentSince Oct 1, 2017 Accepting new patients
Pioneer Medical Group, PL Nurse Practitioner CurrentSince Dec 15, 2024 Accepting new patients
Post Acute Medical PLLC CurrentSince Mar 6, 2023 Accepting new patients
Neuspine Institute LLC CurrentSince Oct 1, 2017 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

1104 N Main St
Bushnell, FL 33513
Phone (352) 568-8777

1851 Elkcam Blvd
Deltona, FL 32725
Phone (386) 789-3769

991 Pondella Rd
North Ft Myers, FL 33903
Phone (239) 994-8809

515 Chesapeake Dr
Tarpon Springs, FL 34689
Phone (727) 934-4629

2590 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 219-3269

38250 A Ave
Zephyrhills, FL 33542
Phone (813) 732-5608

2350 Taft St
Gary, IN 46404
Phone (219) 944-2677

Interoperability endpoints

  • Direct secure messaging: cecily.dubaj.1@14883.direct.athenahealth.com

Organizations & group practices 6

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": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1699292292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 VARICK ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100131917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 VARICK ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100131917",
            "telephone_number": "855-672-2755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11925 Lakemist Cir",
            "address_purpose": "LOCATION",
            "city": "Temple Terrace",
            "state": "FL",
            "postal_code": "336171786",
            "country_code": "US",
            "telephone_number": "813-494-4584",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "190 Riverview St",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "NC",
            "postal_code": "28734",
            "country_code": "US",
            "telephone_number": "828-349-6804",
            "fax_number": "828-349-6808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBAJ",
        "first_name": "CECILY",
        "middle_name": "ALEXANDRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010575",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9336228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CECILY",
            "last_name": "MOORE",
            "middle_name": "ALEXANDRA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.