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Jason P Mccubbin

Internal Medicine

Allopathic & Osteopathic Physicians

200 E Chestnut St Bldg Suite303, Louisville, KY 40202-1831

PECOS Enrollment

This provider is enrolled in PECOS as JASON MCCUBBIN.

Based on the most recent information from CMS, provider Jason P Mccubbin is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1437113396
Provider Type
Individual
Full Name
Mccubbin, Jason P
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
4/17/2006
Last Updated
2/28/2023

Contact Information

Practice Location

200 E Chestnut St Bldg Suite303, Louisville, KY 40202-1831

(502) 629-5552

(502) 629-3132

Mailing Location

PO Box 776351, Chicago, IL 60677-6351

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 41405 Kentucky
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License 41405 Kentucky

Provider Identifiers

ID	Description	Issuer
ID 000000629999	Description Other	Issuer ANTHEM Kentucky
ID K422500	Description Other	Issuer MEDICARE Kentucky
ID 000000548629	Description Other	Issuer ANTHEM- NORTON Kentucky
ID 300070817	Description Medicaid	Issuer Unlisted Indiana
ID 01066001	Description Other	Issuer MEDICARE Kentucky
ID P00470242	Description Other	Issuer RAILROAD MEDICARE- NORTON CMA Kentucky
ID 7100061930	Description Medicaid	Issuer Unlisted Kentucky

Jason P Mccubbin

PECOS Enrollment

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