Individual provider Active NPI

Dante Acebo Cubangbang, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Flushing, NY
National Provider Identifier
1770582124
Registry record updated Jan 21, 2014
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective May 18, 2023.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
234017 Issued in NY
Practice address
13915 34TH Ave
Basement Office
Flushing, NY 11354-3046
Phone
(347) 542-3435
Fax
(347) 542-3539
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 234017 NY Primary

Addresses

Primary practice location

13915 34TH Ave
Basement Office
Flushing, NY 11354-3046

Mailing address

894 Oaks Dr
Franklin Square, NY 11010-1936
Phone (917) 930-9614

Other identifiers 1

IdentifierTypeStateIssuer
02623398MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Huynh Medical, PLLC PastSince Jul 17, 2021 Accepting new patients
Christian Olivares Physical Therapy Services PC Past Accepting new patients
Vicente H Salvador MD PC Past Accepting new patients
Christian Olivares Physical Therapy, PC Past Accepting new patients

Organizations & group practices 4

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1770582124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 OAKS DR",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110101936",
            "telephone_number": "917-930-9614",
            "fax_number": "516-270-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13915 34TH AVE",
            "address_2": "BASEMENT OFFICE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113543046",
            "telephone_number": "347-542-3435",
            "fax_number": "347-542-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUBANGBANG",
        "first_name": "DANTE",
        "middle_name": "ACEBO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "234017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02623398",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.