Individual provider Active NPI

Sydney Louis Cousin Jr., MD

  • Hospitalist Physician
  • Renton, WA
National Provider Identifier
1497954176
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD60217641 Issued in WA
Practice address
400 S 43Rd St
RM 3H-1-053
Renton, WA 98055-5714
Phone
(425) 228-3440
NPI assigned
Jul 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD60217641 WA Primary
Internal Medicine Physician 207R00000X MD60217641 WA

Addresses

Primary practice location

400 S 43Rd St
RM 3H-1-053
Renton, WA 98055-5714

Mailing address

PO Box 34876
Seattle, WA 98124-1876
Phone (425) 656-5412

Other identifiers 2

IdentifierTypeStateIssuer
0279491OtherWAL&I
2012615MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110524000148 WA Practitioner - Internal MedicinePractitioner - Hospitalist 1658423975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
University of Washington School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

16850 SE 272ND St
Covington, WA 98042-4931

400 S 43Rd St
Renton, WA 98055-5714
Phone (425) 228-3450

Hospital & facility affiliations

  • Valley Medical Center Hospital, Renton, WA, CCN 500088
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Internal Medicine CurrentSince Feb 21, 2017 Accepting new patients
Southlake Clinic Inc PS Past Accepting new patients
Public Hospital District 1 of King County Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

4011 Talbot Rd S
Ste 460
Renton, WA 98055
Phone (425) 251-5110

4011 Talbot Rd S
Ste 500
Renton, WA 98055
Phone (425) 251-5110

400 S 43rd St
Rm 3H1053
Renton, WA 98055

Interoperability endpoints

  • Direct secure messaging: scousin11661@direct.valleymed.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1497954176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34876",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241876",
            "telephone_number": "425-656-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "address_2": "RM 3H-1-053",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-228-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSIN",
        "first_name": "SYDNEY",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD60217641",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60217641",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0279491",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2012615",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.