NPIMap

Individual provider Active NPI

Paul Baily Kubin, P.A.

  • Physician Assistant
  • Carmichael, CA
National Provider Identifier
1770833352
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA22486 Issued in CA
Practice address
6651 Madison Ave
Carmichael, CA 95608-0602
Phone
(916) 965-1111
Fax
(916) 965-5143
NPI assigned
Sep 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA22486 CA Primary

Addresses

Primary practice location

6651 Madison Ave
Carmichael, CA 95608-0602

Mailing address

6651 Madison Ave
Carmichael, CA 95608-0602
Phone (916) 965-1111

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131111000432 CA Practitioner - Physician Assistant 2860628351 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sonora Community HospitalGroup PAC ID 4284538505, shared by 10 NPIs, 134 clinicians

Practice addresses (Care Compare)

193 Fairview LN
Sonora, CA 95370-4828
Phone (209) 536-5100

680 Guzzi LN
Suite 206
Sonora, CA 95370-5288
Phone (209) 536-5760

Hospital & facility affiliations

  • Adventist Health Sonora Hospital, Sonora, CA, CCN 050335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA22486CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sonora Community Hospital CurrentSince Apr 1, 2026 Accepting new patients
Sonora Community Hospital CurrentSince Apr 1, 2026 Accepting new patients
Permanente Medical Group, Inc CurrentSince Jan 17, 2023 Accepting new patients
Sonora Community Hospital CurrentSince Apr 1, 2026 Accepting new patients
Permanente Medical Group Inc CurrentSince Jan 17, 2023 Accepting new patients
Pacific Redwood Medical Services Physician Assistant Past Accepting new patients

Locations

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

401 Bicentennial Way
Santa Rosa, CA 95403
Phone (707) 393-4000

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

680 Guzzi Ln
Ste 206
Sonora, CA 95370
Phone (209) 536-5760

193 Fairview Ln
Sonora, CA 95370
Phone (209) 536-5100

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 9

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1770833352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6651 MADISON AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080602",
            "telephone_number": "916-965-1111",
            "fax_number": "916-965-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6651 MADISON AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080602",
            "telephone_number": "916-965-1111",
            "fax_number": "916-965-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIN",
        "first_name": "PAUL",
        "middle_name": "BAILY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-11",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "401 Bicentennial Way",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954032149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.