Active NPI
Kassandra Mae Quibin
- Speech-Language Pathologist
- San Jose, CA
National Provider Identifier
1801418322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 275 Hospital Pkwy
San Jose, CA 95119-1106 - Phone
- (408) 972-6400
- NPI assigned
- May 7, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
275 Hospital Pkwy
San Jose, CA 95119-1106
Mailing address
35103 Perry Rd
Union City, CA 94587-5231
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
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- Santa Clara, CA
- NPI 1073606299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1801418322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35103 PERRY RD",
"city": "UNION CITY",
"state": "CA",
"postal_code": "945875231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 HOSPITAL PKWY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951191106",
"telephone_number": "408-972-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUIBIN",
"first_name": "KASSANDRA",
"middle_name": "MAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-07",
"last_updated": "2022-03-21",
"certification_date": "2022-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"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": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "275 Hospital Pkwy",
"city": "San Jose",
"state": "CA",
"country_code": "US",
"postal_code": "951191106",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.