Michael Adam Russell, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

BP10036622 Issued in TX

Practice address

8517 FM 1826 BLDG 2
Austin, TX 78737-1473

Phone

(512) 416-0044

Fax

(512) 462-9765

NPI assigned

May 14, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Family Practice

Education

University of North Texas HSC, College of Osteopathic Med, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Oaks Family Medicine, P.a.Group PAC ID 5294884995, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Progressive Home Health Agency Home health agency, Buda, TX, CCN 453125

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• South Oaks Family Medicine, P.a.

  • Primary Care Clinic/Center
  • Austin, TX
  • NPI 1184754038

  Family Medicine

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• FDN Enterprises LLC

  dba Progressive Home Health Agency

  • Home Health Agency
  • Buda, TX
  • NPI 1053525006
  Care Compare affiliation

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1023336039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8517 FM 1826 BLDG 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787371473",
            "telephone_number": "512-416-0044",
            "fax_number": "512-462-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8517 FM 1826 BLDG 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787371473",
            "telephone_number": "512-416-0044",
            "fax_number": "512-462-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MICHAEL",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-14",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10036622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE",
            "identifier": "1184754038",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaye Russell, PT
• Katie Russell
• Kimberly A Russell, CRNA
• Mackenzie Ann Russell, OTD
• Merrill Wiley Russell III, D.D.S.
• Millian Russell
• Peggy M Russell, D.O.
• Shannon Louise Russell, PT, DPT
• Shelly Russell, LCSW
• Sheryl Russell, LM, IBCLC

• Family Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.