Individual provider Active NPI

Mariola B Kubicka, MD

  • Allergy & Immunology Physician
  • Rochester, NY
National Provider Identifier
1902874167
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
164775 Issued in NY
Practice address
300 Meridian Centre
Ste 300
Rochester, NY 14618-3984
Phone
(585) 442-0150
Fax
(585) 271-8704
NPI assigned
Mar 14, 2006
Last updated
Dec 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 164775 NY Primary

Addresses

Primary practice location

300 Meridian Centre
Ste 300
Rochester, NY 14618-3984

Mailing address

300 Meridian Centre
Ste 300
Rochester, NY 14618-3984
Phone (585) 442-0150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110125001233 NY Practitioner - Allergy/Immunology 6800075672 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
164775NYMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Asthma Immunology of Rochester, PC Allergy & Immunology CurrentSince Sep 3, 2002 Accepting new patients

Locations

3170 West St
Ste 222
Canandaigua, NY 14424
Phone (585) 271-1620

6800 Pittsford Palmyra Rd
Ste 400
Fairport, NY 14450
Phone (585) 425-1650

300 Meridian Centre Blvd
Ste 300
Rochester, NY 14618
Phone (585) 442-0150

3136 Winton Rd S
Ste 203
Rochester, NY 14623
Phone (585) 442-0150

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1902874167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MERIDIAN CENTRE",
            "address_2": "STE 300",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183984",
            "telephone_number": "585-442-0150",
            "fax_number": "585-271-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MERIDIAN CENTRE",
            "address_2": "STE 300",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183984",
            "telephone_number": "585-442-0150",
            "fax_number": "585-271-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBICKA",
        "first_name": "MARIOLA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "164775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.