Individual provider Active NPI

Russell R McCaig, P.A.

  • Physician Assistant
  • El Dorado, KS
National Provider Identifier
1013983949
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1500485 Issued in KS
Practice address
700 W Central Ave
Ste 205
El Dorado, KS 67042-2184
Phone
(316) 321-2010
Fax
(316) 321-8871
NPI assigned
Feb 28, 2006
Last updated
Apr 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1500485 KS Primary

Addresses

Primary practice location

700 W Central Ave
Ste 205
El Dorado, KS 67042-2184

Mailing address

700 W Central Ave
Ste 205
El Dorado, KS 67042-2184
Phone (316) 321-2010

Other identifiers 1

IdentifierTypeStateIssuer
100343970AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050503000920 KS Practitioner - Physician Assistant 2466492061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susan B Allen Memorial HospitalGroup PAC ID 7719898980, 26 clinicians
El Dorado Clinic, P.a.Group PAC ID 7911944897, 6 clinicians

Practice addresses (Care Compare)

401 W 7TH Ave
Augusta, KS 67010-1309

620 W Central Ave
Sba Urgent Clinic
El Dorado, KS 67042-2111
Phone (316) 452-5860

700 W Central Ave
Suite 205
El Dorado, KS 67042-2186
Phone (316) 321-2010

720 W Central Ave
El Dorado, KS 67042-2112

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1500485KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Susan B. Allen Memorial Hospital Current Accepting new patients
Susan B. Allen Memorial Hospital CurrentSince Sep 4, 2021 Accepting new patients
El Dorado Clinic, P.a. CurrentSince Nov 17, 1998 Accepting new patients

Locations

401 W 7th Ave
Ste 101
Augusta, KS 67010
Phone (316) 321-3300

2710 W Central Ave
El Dorado, KS 67042
Phone (316) 452-5860

620 W Central Ave
Ste 2
El Dorado, KS 67042

700 W Central Ave
Ste 205
El Dorado, KS 67042
Phone (316) 321-2010

720 W Central Ave
El Dorado, KS 67042
Phone (316) 321-3000

Interoperability endpoints

  • Direct secure messaging: rmccaig@eldoradoclinic.azalea.phimailbox.com
  • Direct secure messaging: russ.mccaig@directsbamh.org
  • Direct secure messaging: russ.mccaig@khindirect.org

Organizations & group practices 4

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 1

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1013983949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W CENTRAL AVE",
            "address_2": "STE 205",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670422184",
            "telephone_number": "316-321-2010",
            "fax_number": "316-321-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W CENTRAL AVE",
            "address_2": "STE 205",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670422184",
            "telephone_number": "316-321-2010",
            "fax_number": "316-321-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAIG",
        "first_name": "RUSSELL",
        "middle_name": "R",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1500485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100343970A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, KS

Sources for this page

Verify at the official NPI Registry.