Individual provider Active NPI

Michael Kubek IV, D.O.

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1922270933
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
02003348A Issued in IN
Practice address
720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone
(317) 880-3900
NPI assigned
Mar 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 02003348A IN Primary
Emergency Medicine Physician 207P00000X 5101016047 MI

Addresses

Primary practice location

720 Eskenazi Ave
Indianapolis, IN 46202-5187

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

19805 Crystal Lake Dr
Northville, MI 48167-2522
Phone (248) 449-6425

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkubek@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20080617000083 IN Practitioner - Emergency Medicine 3274604418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101016047MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1206 E National Ave
Brazil, IN 47834
Phone (812) 442-2480

1331 S A St
Elwood, IN 46036
Phone (765) 552-4000

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

801 N State St
Greenfield, IN 46140
Phone (317) 462-5544

8602 Allisonville Rd
Indianapolis, IN 46250
Phone (317) 703-1970

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

2412 E Main St
Plainfield, IN 46168
Phone (317) 204-6800

1300 N Main St
Rushville, IN 46173
Phone (317) 802-3106

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

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.

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1922270933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 ESKENAZI AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025187",
            "telephone_number": "317-880-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19805 Crystal Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481672522",
            "country_code": "US",
            "telephone_number": "248-449-6425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBEK",
        "first_name": "MICHAEL",
        "name_suffix": "IV",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02003348A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101016047",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkubek@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "720 Eskenazi Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.