Theresa Burgess Kubicki, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0101275 Issued in NC

Practice address

222 Ashville Ave
Cary, NC 27518-6130

Phone

(919) 859-1136

Fax

(919) 859-4240

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tkubicki7455@directhisp.wakemed.org

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.

• Wake Specialty Physicians LLC

  • Family Medicine Physician
  • Apex, NC
  • NPI 1609511765
  NPD
• Wakemed Specialists Group LLC

  • Cardiac Rehabilitation Registered Nurse
  • Raleigh, NC
  • NPI 1063304228
  NPD
• Wakemed Specialists Group, LLC

  • Infectious Disease Physician
  • Raleigh, NC
  • NPI 1497431837
  NPD
• Raleigh Durham Medical Group PA

  • Family Medicine Physician
  • Cary, NC
  • NPI 1295784874
  NPD (past)
• Wake Specialty Physicians, LLC

  • Surgery Physician
  • Raleigh, NC
  • NPI 1942440375

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1801949474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010",
            "telephone_number": "877-498-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 ASHVILLE AVE",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275186130",
            "telephone_number": "919-859-1136",
            "fax_number": "919-859-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBICKI",
        "first_name": "THERESA",
        "middle_name": "BURGESS",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101275",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0101275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkubicki7455@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "212 Ashville Ave",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275116669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kroger Limited Partnership I
• Brennan Kroll, PHARMD
• Brianna Krout, D.C.
• Christie Krumwiede
• Abigail Kruszka
• Suzanne Kuebler, BT
• Emma Kuehnle, LMFTA
• Michelle Lyn Kuerbitz, FNP
• Robin L Kuhls, OTR/L
• Lillian Kui

• Medical Physician Assistant in Cary, NC
• Providers in Cary, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.