Individual provider Active NPI

Joseph Anthony Kebisek, M.D.

  • Emergency Medicine Physician
  • Farmington, CT
National Provider Identifier
1851824262
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
305329 Issued in NY
Practice address
263 Farmington Ave
Farmington, CT 06032-1956
Phone
(860) 679-2147
NPI assigned
Apr 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 305329 NY Primary
Emergency Medicine Physician 207P00000X MD17194 RI
Emergency Medicine Physician 207P00000X 69935 CT
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

263 Farmington Ave
Farmington, CT 06032-1956

Mailing address

263 Farmington Ave
Farmington, CT 06032-1956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 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
I20200819003786 NY Practitioner - Emergency Medicine 3274805320 Reassigns benefits to 2 organizations
I20221212000152 FL Practitioner - Emergency Medicine 3274805320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Wisconsin School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahassee Memorial Healthcare IncGroup PAC ID 6103724778, 498 clinicians
TMH Emergency Physician GroupGroup PAC ID 8325317084, 48 clinicians

Practice addresses (Care Compare)

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (850) 877-5183

Hospital & facility affiliations

  • Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Emergency Physician Group Emergency Medicine CurrentSince Dec 1, 2022 Accepting new patients
TMH Emergency Physician Group Emergency Medicine CurrentSince Jul 24, 2022 Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Dec 1, 2022 Accepting new patients
Emergency Care Services of New York, P.C. Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Dec 1, 2022 Accepting new patients
Buffalo Emergency Associates LLP Emergency Medicine CurrentSince Apr 1, 2021 Accepting new patients

Locations

15 Council Moore Rd
Crawfordville, FL 32327
Phone (850) 926-7105

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1260 Metropolitan Blvd
Tallahassee, FL 32312
Phone (850) 422-5413

1609 Physicians Dr
Tallahassee, FL 32308
Phone (850) 431-4243

307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

Interoperability endpoints

  • Direct secure messaging: jkebisek22007@tallahasseememorial.direct-ci.com

Organizations & group practices 7

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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1851824262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321956",
            "telephone_number": "860-679-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBISEK",
        "first_name": "JOSEPH",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "305329",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "MD17194",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "69935",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.