Active NPI
John A Hubicki, PA
- Medical Physician Assistant
- Port Charlotte, FL
National Provider Identifier
1992038426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9103010
- Practice address
- 3109 Tamiami TRL
Suite 3
Port Charlotte, FL 33952-8046 - Phone
- (941) 629-3000
- Fax
- (941) 629-6711
- NPI assigned
- Sep 16, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9103010 | FL | Primary |
Addresses
Primary practice location
3109 Tamiami TRL
Suite 3
Port Charlotte, FL 33952-8046
Mailing address
3109 Tamiami TRL
Suite 3
Port Charlotte, FL 33952-8046
Phone (941) 629-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9103010 | FL | MD | Medical Physician Assistant |
Interoperability endpoints
- john.hubicki.1@3611.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253059200000",
"number": "1992038426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3109 TAMIAMI TRL",
"address_2": "SUITE 3",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339528046",
"telephone_number": "941-629-3000",
"fax_number": "941-629-6711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3109 TAMIAMI TRL",
"address_2": "SUITE 3",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339528046",
"telephone_number": "941-629-3000",
"fax_number": "941-629-6711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBICKI",
"first_name": "JOHN",
"middle_name": "A",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-16",
"last_updated": "2009-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9103010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.