Organization Active NPI

Susan M Kubica MD Professional Corporation

  • Clinic/Center
  • Monterey, CA
National Provider Identifier
1700909256
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SUSAN M KUBICA MD PROFESSIONAL CORPORATION
Practice address
1000 8TH St
Suite 101
Monterey, CA 93940-3664
Phone
(831) 372-1188
Fax
(831) 372-1181
NPI assigned
Apr 9, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Susan M Kubica, MDNPI 1245321876
Title
Physician
Phone
(831) 372-1188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2038116Susan M Kubica MD1000 8TH St Ste 101, Monterey, CA 93940Certificate of waiverMar 12, 2028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070717000386 CA Part B Supplier - Clinic/Group Practice 6608976840 Receives reassigned benefits from 2 practitioners
Practice locations: Monterey, CA

National Provider Directory

National Provider Directory

Locations

1000 8th St
Ste 101
Monterey, CA 93940
Phone (831) 372-1188

1000 8th St
Ste 100
Monterey, CA 93940

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1000 8TH St
Suite 101
Monterey, CA 93940-3664

Mailing address

1000 8TH St
Suite 101
Monterey, CA 93940-3664
Phone (831) 372-1188

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
ZZZ05146ZOtherCAMEDICARE PROVIDER

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 27, 2007.

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1700909256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 8TH ST",
            "address_2": "SUITE 101",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403664",
            "telephone_number": "831-372-1188",
            "fax_number": "831-372-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 8TH ST",
            "address_2": "SUITE 101",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403664",
            "telephone_number": "831-372-1188",
            "fax_number": "831-372-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN M KUBICA MD PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "KUBICA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "831-372-1188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "ZZZ05146Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.