Individual provider Active NPI

Mark D Cousineau, MD

  • Emergency Medicine Physician
  • Portland, ME
National Provider Identifier
1477634335
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
EC-05-081 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-7050
Fax
(207) 662-7054
NPI assigned
Oct 18, 2006
Last updated
Mar 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 59926 KY
Emergency Medicine Physician 207P00000X EC-05-081 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-7050

Other identifiers 1

IdentifierTypeStateIssuer
490446404AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN, NC, VA, WV, AR, KY7 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
I20071112000475 GA Practitioner - Emergency Medicine 7113015991 Reassigns benefits to 3 organizations
I20130618000139 TN Practitioner - Emergency Medicine 7113015991 Reassigns benefits to 3 organizations
I20131113000440 NC Practitioner - Emergency Medicine 7113015991 Reassigns benefits to 2 organizations
I20141109000006 VA Practitioner - Emergency Medicine 7113015991 Reassigns benefits to 1 organization
I20181226002373 WV Practitioner - Emergency Medicine 7113015991 Reassigns benefits to 2 organizations
I20210821000321 AR Practitioner - Emergency Medicine 7113015991 Reassigns benefits to 1 organization
I20260218000839 KY Practitioner - Emergency Medicine 7113015991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 278-2105

1607 S Locust Ave Hwy 43
Lawrenceburg, TN 38464-4011
Phone (931) 762-6571

175 Hospital Dr
Winchester, KY 40391-9591
Phone (859) 745-3500

1808 W Main St
Russellville, AR 72801-2724
Phone (501) 968-2841

288 S Ridgecrest Ave
Rutherfordton, NC 28139-2838
Phone (828) 286-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59926KYMDEmergency Medicine Physician
EC-05-081MEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince May 20, 2013 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Mar 1, 2013 Accepting new patients
Greenbrier Emergency Services, Inc. Emergency Medicine CurrentSince Apr 21, 2024 Accepting new patients
Health Care Alliance, Inc. Emergency Medicine CurrentSince Nov 1, 2018 Accepting new patients
Inphynet Primary Care Physicians Southeast PC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Montgomery Emergency Group, LLC Emergency Medicine CurrentSince Nov 1, 2012 Accepting new patients
T M Carr MD PC Emergency Medicine CurrentSince Apr 30, 2025 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine Past Accepting new patients

Locations

1 Medical Park Dr
Bryant, AR 72015
Phone (501) 776-6000

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1025 New Moody Ln
Lagrange, KY 40031
Phone (502) 222-3335

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

175 Hospital Dr
Winchester, KY 40391
Phone (859) 745-3500

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

400 E Tickle St
Dyersburg, TN 38024
Phone (731) 285-2410

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

601 Colliers Way
Weirton, WV 26062
Phone (304) 364-5156

Interoperability endpoints

  • Direct secure messaging: mark.cousineau.1@26499.direct.athenahealth.com
  • Direct secure messaging: markcousineau@arh.medalliesdirect.net

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1477634335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-7050",
            "fax_number": "207-662-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-7050",
            "fax_number": "207-662-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSINEAU",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "59926",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "EC-05-081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490446404A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.