NPIMap

Individual provider Active NPI

Miguel Eduardo Cossio, M.D.

  • Internal Medicine Physician
  • Madison, GA
National Provider Identifier
1669426557
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
025337 Issued in GA
Practice address
1075 S Main St
Suite 400
Madison, GA 30650-2033
Phone
(706) 342-9664
NPI assigned
May 22, 2006
Last updated
Jun 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 025337 GA Primary

Addresses

Primary practice location

1075 S Main St
Suite 400
Madison, GA 30650-2033

Mailing address

1075 S Main St
Suite 400
Madison, GA 30650-2033
Phone (706) 342-9664

Other identifiers 1

IdentifierTypeStateIssuer
000289517AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051214000808 GA Practitioner - Internal MedicinePractitioner - Family Practice 1850312166 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1075 S Main St
Suite 400
Madison, GA 30650-2050
Phone (706) 342-9664

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025337GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morgan County Georgia Hospital Authority Current Accepting new patients
Miguel E. Cossio M.D., P.C. Internal Medicine CurrentSince Jul 1, 1984 Accepting new patients

Locations

1075 S Main St
Ste 400
Madison, GA 30650
Phone (706) 342-7547

1077 S Main St
Madison, GA 30650
Phone (706) 342-0449

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DHCEAD
  • FHIR API: https://fhir4.healow.com/fhir/r4/DHCEAD/Endpoint/DHCEAD
  • Direct secure messaging: miguelcossio@mmc.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1669426557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 S MAIN ST",
            "address_2": "SUITE 400",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306502033",
            "telephone_number": "706-342-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 S MAIN ST",
            "address_2": "SUITE 400",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306502033",
            "telephone_number": "706-342-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSSIO",
        "first_name": "MIGUEL",
        "middle_name": "EDUARDO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "025337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000289517A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, GA

Sources for this page

Verify at the official NPI Registry.