Individual provider Active NPI

Jordan Ibrahim Cusick

  • Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1356199913
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP.AP.70035123-NP Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-0001
Phone
(206) 520-5000
NPI assigned
May 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X ARNP.AP.70035123-NP WA
Nurse Practitioner 363L00000X ARNP.AP.70035123-NP WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-0001

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Other practice location 1

1550 N 115th St
Seattle, WA 98133-8401
Phone (877) 694-4677

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
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1959 NE Pacific St
Seattle, WA 98195-0001

850 Republican St
Seattle, WA 98109-4725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN61004355WAMDMedical-Surgical Registered Nurse
AP70035123WAMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1356199913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 N 115th St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981338401",
            "country_code": "US",
            "telephone_number": "877-694-4677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSICK",
        "first_name": "JORDAN",
        "middle_name": "IBRAHIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-08",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "ARNP.AP.70035123-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "ARNP.AP.70035123-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.