NPIMap

Individual provider Active NPI

Daniel J Coughlin, M.D.

  • Neurological Surgery Physician
  • Tacoma, WA
National Provider Identifier
1629363213
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD60955538 Issued in WA
Practice address
9040 Jackson Ave
Tacoma, WA 98431-0001
Phone
(253) 968-1110
NPI assigned
Jun 13, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 60955538 WA
Neurological Surgery Physician 207T00000X MD60955538 WA Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-0001

Mailing address

9040 Jackson Ave
Tacoma, WA 98431-0001

Other practice location 1

888 Swift Blvd
Richland, WA 99352-3514
Phone (509) 946-4611

Other practice location 2

1608 S J St Fl 5
Tacoma, WA 98405-4930
Phone (253) 274-7505

Other identifiers 1

IdentifierTypeStateIssuer
2142427MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dcoughlin577163@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191120003165 WA Practitioner - Neurosurgery 5294967014 Reassigns benefits to 2 organizations
I20221031000873 SD Practitioner - Neurosurgery 5294967014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Uniformed Services Uhs Fe Hebert School of Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1301 S Cliff Ave
Suite 610
Sioux Falls, SD 57105-1032
Phone (605) 322-8860

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion29
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60955538WAMDNeurological Surgery Physician
MD60955538WAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 CurrentSince Dec 1, 2020 Accepting new patients
Avera McKennan Neurological Surgery CurrentSince Sep 1, 2022 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Overlake Medical Clinics LLC CurrentSince Jan 6, 2021 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Dec 1, 2020 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Sep 1, 2022 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients
Alegent Creighton Clinic Hospitalist Past Accepting new patients

Locations

1301 S Cliff Ave
Ste 610
Sioux Falls, SD 57105
Phone (605) 322-8860

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

12039 NE 128th St
Ste 500
Kirkland, WA 98034
Phone (425) 899-1220

Interoperability endpoints

  • Direct secure messaging: daniel.coughlin@avera.sdhealthlink.net
  • Direct secure messaging: dcoughlin577163@fhsce.catholichealth.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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1629363213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "888 Swift Blvd",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523514",
            "country_code": "US",
            "telephone_number": "509-946-4611",
            "fax_number": "509-942-2812",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1608 S J St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054930",
            "country_code": "US",
            "telephone_number": "253-274-7505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COUGHLIN",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WA",
            "license": "60955538",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WA",
            "license": "MD60955538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2142427",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcoughlin577163@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1608 S J St Fl 5",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.