MRS. SUJATA C POISSON (M.D.) – Neurology Physician, NPI 1245394170

MRS. SUJATA C POISSON (M.D.) is a healthcare provider. based in Renton, Washington. specializing in Neurology Physician. They hold the professional credentials M.D.. They hold a License No. MD00031741 (WA). The NPI Number for MRS. SUJATA C POISSON (M.D.) is 1245394170

Main info

Female
Sole Proprietor
43 Years Of Experience
Accepts Medicare Assignment
Name
MRS. SUJATA C POISSON (M.D.)
NPI
1245394170
Phone
(425) 690-2715
Address
3600 LIND AVE SW
Enumeration Date
22 December 2006
Last Update Date
4 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4252283450
Graduation Year
1983 (43 years ago)
PAC ID
2668631623
Group Practice PAC ID
4183753965
Professional Enrollment ID
I20120309000677
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for MRS. SUJATA C POISSON (M.D.)

  • Home Depot Kitchen & Bathroom Refacing, 3600, Lind Avenue Southwest, Renton, King County, Washington, 98055, United States

    SUITE 100 ATTN CREDENTIALING

    RENTON, WA 980574970

    Phone: (425) 690-2715

    Type: Mailing

  • Valley Medical Center, 400, South 43rd Street, Renton, King County, Washington, 98055, United States

    RENTON, WA 98055

    Phone: (425) 656-5566

    Fax: (425) 656-5567

    Type: Location

  • 34617 11 place south

    The Neurology clinic Suite#100

    Federal Way, WA 98003

    Phone: (253) 924-0871

    Fax: (253) 924-0926

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-03-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120309000677INeurologyWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98057)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183753965View full group profile
NameSpecialtyState
Family PracticeWA
Physical Therapist In Private PracticeWA
Internal Medicine, HospitalistWA
P S Y C H I A T R YWA
Hospice/Palliative Care, Internal MedicineWA
Internal Medicine, HospitalistCA
Family PracticeWA
Family Practice, Emergency MedicineWA
-WA
-WA

Reviews

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Frequently asked questions

What federal number belongs to MRS. SUJATA C POISSON (M.D.)?
The federal identifier for MRS. SUJATA C POISSON (M.D.) is NPI 1245394170.
Is MRS. SUJATA C POISSON (M.D.) active in the national directory?
MRS. SUJATA C POISSON (M.D.)'s public NPI profile is in an active state.
Can you summarize MRS. SUJATA C POISSON (M.D.)'s specialty in plain language?
Clinically, the directory lists MRS. SUJATA C POISSON (M.D.) with Neurology Physician. Clinical services aligned with this taxonomy classification.
Where is MRS. SUJATA C POISSON (M.D.)'s primary listing?
We display Renton, Washington because that is what the record indicates for MRS. SUJATA C POISSON (M.D.).
What if Renton, Washington seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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