Organization Active NPI

Donald P. Cousineau DO PC

  • General Practice Physician
  • Gaylord, MI
National Provider Identifier
1386645851
Registry record updated Mar 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
DC006878 Issued in MI
Legal business name
DONALD P. COUSINEAU DO PC
Practice address
994 N Center Ave
Gaylord, MI 49735-9375
Phone
(989) 732-7843
Fax
(989) 731-4513
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2010

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

Authorized official

Name
Dr. Donald Paul Cousineau, DONPI 1841485133
Title
Physician
Phone
(989) 732-7843

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X DC006878 MI Primary

Addresses

Primary practice location

994 N Center Ave
Gaylord, MI 49735-9375

Mailing address

994 N Center Ave
Gaylord, MI 49735-9375
Phone (989) 732-7843

Other identifiers 1

IdentifierTypeStateIssuer
1089781MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421000975 MI Part B Supplier - Clinic/Group Practice 5991791402 Receives reassigned benefits from 1 practitioner
Practice locations: Gaylord, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0381664Donald P Cousineau DO994 North Center Ave, Gaylord, MI 49735Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory

Locations

994 N Center Ave
Gaylord, MI 49735
Phone (989) 732-3450

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or 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-2",
    "last_updated_epoch": "1269561600000",
    "number": "1386645851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 N CENTER AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359375",
            "telephone_number": "989-732-7843",
            "fax_number": "989-731-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 N CENTER AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359375",
            "telephone_number": "989-732-7843",
            "fax_number": "989-731-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD P. COUSINEAU DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2010-03-26",
        "status": "A",
        "authorized_official_last_name": "COUSINEAU",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "989-732-7843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "DC006878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1089781",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaylord, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.