Active NPI
Virginia L Kubic, MD
- Specialist
- Minneapolis, MN
National Provider Identifier
1992740047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 33111
- Practice address
- 701 Park Ave
Minneapolis, MN 55415-1623 - Phone
- (612) 873-2990
- NPI assigned
- Jun 20, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 33111 | MN | Primary |
Addresses
Primary practice location
701 Park Ave
Minneapolis, MN 55415-1623
Mailing address
701 Park Ave
Minneapolis, MN 55415-1623
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 482202100 | Medicaid | MN |
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184889600000",
"number": "1992740047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 PARK AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 PARK AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151623",
"telephone_number": "612-873-2990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUBIC",
"first_name": "VIRGINIA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-20",
"last_updated": "2007-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MN",
"license": "33111",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "482202100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.