Individual provider Active NPI

Jimmy Yi Cui, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Mount Vernon, WA
National Provider Identifier
1720057342
Registry record updated Feb 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
MD00039814 Issued in WA
Practice address
1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone
(360) 424-2400
Fax
(360) 424-2418
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X MD00039814 WA Primary

Addresses

Primary practice location

1401 S Laventure Rd
Mount Vernon, WA 98274-6033

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other identifiers 1

IdentifierTypeStateIssuer
8288169MedicaidWA

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
I20040922001028 WA Practitioner - Physical Medicine and Rehabilitation 5294703617 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00039814WAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S CurrentSince Aug 1, 2002 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Aug 1, 2002 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients

Locations

2720 Commercial Ave
Anacortes, WA 98221
Phone (360) 299-1300

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

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.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1720057342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S LAVENTURE RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982746033",
            "telephone_number": "360-424-2400",
            "fax_number": "360-424-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUI",
        "first_name": "JIMMY",
        "middle_name": "YI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WA",
            "license": "MD00039814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8288169",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.