Individual provider Active NPI

Paul Richard Cauchon, PA-C

  • Physician Assistant
  • Bethesda, MD
National Provider Identifier
1063413342
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C003414 Issued in MD
Practice address
Internal Medicine Clinic N.N.M.C.
BLDG 19, 8901 Wisconsin Ave
Bethesda, MD 20889-0001
Phone
(301) 319-8750
Fax
(301) 319-4712
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C003414 MD Primary

Addresses

Primary practice location

Internal Medicine Clinic N.N.M.C.
BLDG 19, 8901 Wisconsin Ave
Bethesda, MD 20889-0001

Mailing address

Internal Medicine Clinic N.N.M.C.
BLDG 19, 8901 Wisconsin Ave
Bethesda, MD 20889-0001
Phone (301) 319-8750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130517000169 MD Order and Referring Only - Physician Assistant 5193962884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C003414MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1063413342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "INTERNAL MEDICINE CLINIC N.N.M.C.",
            "address_2": "BLDG 19, 8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-319-8750",
            "fax_number": "301-319-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INTERNAL MEDICINE CLINIC N.N.M.C.",
            "address_2": "BLDG 19, 8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-319-8750",
            "fax_number": "301-319-4712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUCHON",
        "first_name": "PAUL",
        "middle_name": "RICHARD",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C003414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.