Richard E Seroussi, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD00031281 Issued in WA

Practice address

3213 Eastlake Ave E
Suite a
Seattle, WA 98102-3826

Phone

(206) 861-8200

Fax

(206) 324-1178

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Renton Spine and Sports Medicine LLC

  • Physical Medicine & Rehabilitation Physician
  • Renton, WA
  • NPI 1407324304
  NPD (past)
• Susan Schmitt

  • Rehabilitation Practitioner
  • Seattle, WA
  • NPI 1427228980
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1992722698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3213 EASTLAKE AVE E",
            "address_2": "SUITE A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023826",
            "telephone_number": "206-861-8200",
            "fax_number": "206-324-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3213 EASTLAKE AVE E",
            "address_2": "SUITE A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023826",
            "telephone_number": "206-861-8200",
            "fax_number": "206-324-1178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Oakesdale Ave SW Ste 100",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980575202",
            "country_code": "US",
            "telephone_number": "425-800-9757",
            "fax_number": "425-800-9756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEROUSSI",
        "first_name": "RICHARD",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD00031281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "158738",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RIDER NUMBER",
            "identifier": "9006SE",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8179723",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Didem Serin
• Delaney Pinion Serio, M.A., BCBA. LBA
• Camilo Serna Gomez
• Matthew Andrew Serna
• Daniel Seroussi
• Mariana Gomes Serpa, MD
• Casey Elizabeth Serrano, ARNP
• Culbert M. Serrano, M.D.
• Daniela Serrano
• Monica C. Serrano, PHARMD

• Physical Medicine & Rehabilitation Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.