Melissa Kubick, OD

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

TA1316 Issued in MD

Practice address

11110 Mall Cir
Waldorf, MD 20603-4803

Phone

(301) 705-8383

Fax

(301) 705-8388

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Daniel Poth, O.D. and Associates, P.C.

  • Optometrist
  • Vienna, VA
  • NPI 1154354041

  DC

  Medicare reassignment NPD
• Daniel Poth, O.D. and Associates, P.C.

  • Eyewear Supplier
  • Fairfax, VA
  • NPI 1093459182

  Corneal and Contact Management

  NPD

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1982829487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "SUITE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6509",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MALL CIR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034803",
            "telephone_number": "301-705-8383",
            "fax_number": "301-705-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBICK",
        "first_name": "MELISSA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MD",
            "license": "TA1316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KP Global Solutions LLC
• Gabriel Kresge, PT
• Elena Krestinicheva
• Krishan M Mathur MD
• Amanda Jayne Kromer, N.P
• Gowri Kularatna, M.D.
• Alexis Kurtianyk, OT
• Nishani Kuruppu, DPM
• Jane Kutsushi, NP
• Athanasia Kyriazis

• Corneal and Contact Management Optometrist in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Corneal and Contact Management Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.