Individual provider Active NPI

Richard Eugene Cook Jr., M.D.

  • Internal Medicine Physician
  • Waldorf, MD
National Provider Identifier
1811970056
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
Practice address
3450 Old Washington Rd
Suite 103
Waldorf, MD 20602-3248
Phone
(301) 472-4290
Fax
(240) 607-3609
NPI assigned
Nov 22, 2005
Last updated
Jul 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0063483 MD Primary

Addresses

Primary practice location

3450 Old Washington Rd
Suite 103
Waldorf, MD 20602-3248

Mailing address

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

Other practice location 1

600 Holiday Plaza Dr Ste 501
Matteson, IL 60443-2359
Phone (312) 437-1023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20051025001114 MD Practitioner - Internal Medicine 2567489909 Reassigns benefits to 3 organizations
I20150309001702 DC Practitioner - Internal Medicine 2567489909 Reassigns benefits to 2 organizations
I20240731001990 TN Practitioner - Internal Medicine 2567489909

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook and Siu PCGroup PAC ID 6406997550, 2 clinicians

Practice addresses (Care Compare)

3450 Old Washington Rd
Suite 103
Waldorf, MD 20602-3249
Phone (301) 472-4290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0063483MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Internal Medicine CurrentSince Jan 29, 2015 Accepting new patients
Menocal Medical Services PA Current Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Oct 3, 2018 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Oct 3, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince Jan 29, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4910 Massachusetts Ave NW
Ste 114
Washington, DC 20016
Phone (202) 244-0812

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

301 Saint Paul St
Ste 409
Baltimore, MD 21202
Phone (410) 659-7041

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

12070 Old Line Ctr
Ste 302
Waldorf, MD 20602
Phone (301) 645-6667

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

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

Interoperability endpoints

  • Direct secure messaging: richard.cook.1@20527.direct.athenahealth.com

Organizations & group practices 7

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 2

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720828800000",
    "number": "1811970056",
    "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": "240-607-3609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 OLD WASHINGTON RD",
            "address_2": "SUITE 103",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023248",
            "telephone_number": "301-472-4290",
            "fax_number": "240-607-3609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Holiday Plaza Dr Ste 501",
            "address_purpose": "LOCATION",
            "city": "Matteson",
            "state": "IL",
            "postal_code": "604432359",
            "country_code": "US",
            "telephone_number": "312-437-1023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "RICHARD",
        "middle_name": "EUGENE",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2024-07-13",
        "certification_date": "2024-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0063483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.