Stephen Michael Kubaska III, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

000000G86545 Issued in CA

Practice address

1211 W. la Palma Avenue
Suite 505
Anaheim, CA 92801-2812

Phone

(714) 778-1032

Fax

(714) 780-0053

NPI assigned

Oct 16, 2006

Last updated

Aug 24, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• San Fernando Valley Interventional Radiology and Imaging Center

  • Vascular-Interventional Technology Radiologic Technologist
  • Encino, CA
  • NPI 1942350889
  Medicare reassignment NPD
• Arizona Diagnostic Radiology Group, LLC

  • Diagnostic Radiology Physician
  • Gilbert, AZ
  • NPI 1336757699
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1952481160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W. LA PALMA AVENUE",
            "address_2": "SUITE 505",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012812",
            "telephone_number": "714-778-1032",
            "fax_number": "714-780-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W. LA PALMA AVENUE",
            "address_2": "SUITE 505",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012812",
            "telephone_number": "714-778-1032",
            "fax_number": "714-780-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBASKA",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "000000G86545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G865450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lydia Kropidlowski, PMHNP
• Patrick Ikaika Kruger
• David William Kruse, MD
• Ku Natural Medicine Clinic, Inc.
• Xuan Kuang
• Sandra G. Kubicki, PSY.D.
• Anna Kubo
• Kevin D Kuettel, M.D.
• Preethy Mathew Kulakat, NP
• Amir Kullovaguzman

• Vascular Surgery Physician in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.