Individual provider Active NPI

Martin A Kubeja, MD

  • Anesthesiology Physician
  • Tacoma, WA
National Provider Identifier
1821195140
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD00038533 Issued in WA
Practice address
1901 S Union Ave
Tacoma, WA 98405-1702
Phone
(253) 459-6611
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD00038533 WA Primary

Addresses

Primary practice location

1901 S Union Ave
Tacoma, WA 98405-1702

Mailing address

PO Box 97115
Lakewood, WA 98497-0115
Phone (253) 588-7911

Other identifiers 1

IdentifierTypeStateIssuer
8256729MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200110001826 CA Practitioner - Anesthesiology 1254529761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Columbia University College of Physicians and Surgeons, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Darin Rentz DO PCGroup PAC ID 7315333853, 131 clinicians

Practice addresses (Care Compare)

350 Terracina Blvd
Redlands, CA 92373-4850
Phone (909) 335-5593

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Darin Rentz DO PC Anesthesiology CurrentSince May 1, 2022 Accepting new patients
Sound Anesthesia, LLP Anesthesiology Past Accepting new patients
Tacoma Anesthesia Associates Inc PS Anesthesiology Past Accepting new patients

Locations

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

Organizations & group practices 3

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 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1821195140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97115",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984970115",
            "telephone_number": "253-588-7911",
            "fax_number": "253-984-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S UNION AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051702",
            "telephone_number": "253-459-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBEJA",
        "first_name": "MARTIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00038533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8256729",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.