Kelly M Kubiak, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

36.003911 Issued in OH

Practice address

784 Medina Rd Ste 107
Medina, OH 44256-9634

Phone

(330) 591-9635

Fax

(330) 591-4150

NPI assigned

Apr 10, 2017

Sex

Female

Sole proprietor

No

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.

• Prestige Foot & Ankle Center LLC

  • Foot & Ankle Surgery Podiatrist
  • Medina, OH
  • NPI 1700145372

  Foot & Ankle Surgery, OH

  Medicare reassignment Care Compare group NPD

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

• All 4 Home Care, LLC

  • Home Health Agency
  • Medina, OH
  • NPI 1982890729
  Care Compare affiliation
• Medina Hospital

  • General Acute Care Hospital
  • Medina, OH
  • NPI 1083696710

  Hospital

  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919

  Hospital

  Care Compare affiliation

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prestige Foot and Ankle Center LLC 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accessible Home Health Care of Akron Home health agency, Medina, OH, CCN 368238
• Medina Hospital Hospital, Medina, OH, CCN 360091
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 23, 2021.

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1801329412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 RIFFEL RD STE A",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446918592",
            "telephone_number": "440-856-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 MEDINA RD STE 107",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442569634",
            "telephone_number": "330-591-9635",
            "fax_number": "330-591-4150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 23rd St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Cuyahoga Falls",
            "state": "OH",
            "postal_code": "442231404",
            "country_code": "US",
            "telephone_number": "330-591-4150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBIAK",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2021-11-23",
        "certification_date": "2020-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36.003911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Kruchan, QMHS CMS
• Jordan Krugman, SWT
• Justyna Krupa
• Thomas R. Krupitzer, M.D.
• Kimberly Krzemienieswki, LISW-S
• Troy Kubincanek, RN
• Kunal Mitra MD
• Brittany Kunda
• Kathleen Gayle Kunkle, PH.D.
• Cheryl Darlene Kunkler, LPN

• All providers in Medina, OH
• Foot & Ankle Surgery Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.