Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Andrew Kociubuk, APNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1386241867

Mr. Andrew Kociubuk, APNP is a Nurse Practitioner in North Providence, Rhode Island. Qualified in 2021, 5 years ago. Practices with Group Health Cooperative of South Central Wisconsin, a 234-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Ohio and Wisconsin.

Years since qualifying
5
Licensed in
OH, WI
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

200 High Service Ave
North Providence, RI 02904-5113
Phone: (401) 456-2000
Fax: (401) 456-2445
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 825 Chalkstone Ave, Providence, RI 02908-4728 — (401) 456-2000

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 11039-33 (WI)
Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0808X · Licence RN.466178 (OH)

Record details

NPI number1386241867
Entity typeIndividual (Type 1)
GenderMale
Credentials APNP
Sole proprietorYes
NPI enumeratedOctober 7, 2020
Last updated in NPPESApril 29, 2026
Certification dateApril 29, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Group Health Cooperative Of South Central Wisconsin — 234 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in North Providence