NPIMap

Organization Active NPI

Cook & Siu PC

  • Internal Medicine Physician
  • Waldorf, MD
National Provider Identifier
1780852129
Registry record updated Jul 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0063483 Issued in MD
Legal business name
COOK & SIU PC
Practice address
3450 Old Washington Rd Ste 103
Waldorf, MD 20602-3249
Phone
(301) 472-4290
Fax
(240) 607-3609
NPI assigned
Feb 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2024

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

Authorized official

Name
Richard E Cook Jr., M.D.NPI 1811970056
Title
Owner
Phone
(301) 472-9240

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X D0063483 MD Primary

Addresses

Primary practice location

3450 Old Washington Rd Ste 103
Waldorf, MD 20602-3249

Mailing address

PO Box 215
Bryantown, MD 20617-0215
Phone (301) 472-4290

Other names 1

  • Richard E Cook, MD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100112000021 MD Part B Supplier - Clinic/Group Practice 6406997550 Receives reassigned benefits from 2 practitioners
Practice locations: Waldorf, MD

National Provider Directory

National Provider Directory

Locations

29015 Three Notch Rd
Unit 1A
Mechanicsville, MD 20659
Phone (301) 472-4290

3450 Old Washington Rd
Ste 103
Waldorf, MD 20602
Phone (301) 472-4290

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20527/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720828800000",
    "number": "1780852129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "BRYANTOWN",
            "state": "MD",
            "postal_code": "206170215",
            "telephone_number": "301-472-4290",
            "fax_number": "301-290-5287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 OLD WASHINGTON RD STE 103",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023249",
            "telephone_number": "301-472-4290",
            "fax_number": "240-607-3609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOK & SIU PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2024-07-13",
        "certification_date": "2024-07-13",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-472-9240",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0063483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richard E Cook, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.