Individual provider Active NPI

Cheryl A Kubisty, M.D.

  • Internal Medicine Physician
  • Oak Harbor, WA
National Provider Identifier
1780602490
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26471 Issued in MT
Practice address
830 NE Ireland
Oak Harbor, WA 98277
Phone
(360) 675-7678
Fax
(360) 279-0614
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD00030606 WA
Internal Medicine Physician 207R00000X M-12093 ID
Internal Medicine Physician 207R00000X 26471 MT Primary

Addresses

Primary practice location

830 NE Ireland
Oak Harbor, WA 98277

Mailing address

830 NE Ireland
Oak Harbor, WA 98277
Phone (360) 675-7678

Other identifiers 1

IdentifierTypeStateIssuer
1108687MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070827000529 WA Practitioner - HospitalistPractitioner - Internal Medicine 4385736990 Reassigns benefits to 2 organizations
I20220718002249 MT Practitioner - HospitalistPractitioner - Internal Medicine 4385736990 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CMSC LLCGroup PAC ID 5890602494, 92 clinicians

Practice addresses (Care Compare)

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 424-4111

1509 29TH St S
Great Falls, MT 59405-5363
Phone (406) 771-3500

3000 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 454-2171

3010 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 216-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-12093IDMDInternal Medicine Physician
26471MTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Health CurrentSince Jun 2, 2022 Accepting new patients
St Peter'S Health Current Accepting new patients
South Sound Inpatient Physicians, PLLC Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
Cogent Healthcare of Washington, PC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Hospitalist Medicine Physicians of California - San Leandro, PC Internal Medicine CurrentSince Jan 13, 2020 Accepting new patients
St. Peter'S Health CurrentSince Jun 2, 2022 Accepting new patients
Hospitalist Medicine Physicians of California-San Bernardino, PC Internal Medicine CurrentSince Jan 20, 2020 Accepting new patients
Pocatello Health Services, LLC Current Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

330 S Stillaguamish Ave
Arlington, WA 98223
Phone (360) 435-2133

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

101 N Main St
Coupeville, WA 98239
Phone (360) 678-7656

1415 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 416-5750

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

Interoperability endpoints

  • Direct secure messaging: ckubisty61927@direct.peacehealth.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1780602490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 NE IRELAND",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "98277",
            "telephone_number": "360-675-7678",
            "fax_number": "360-279-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 NE IRELAND",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "98277",
            "telephone_number": "360-675-7678",
            "fax_number": "360-279-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBISTY",
        "first_name": "CHERYL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00030606",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M-12093",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "26471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1108687",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

Verify at the official NPI Registry.