Raymond Richard Russell, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

038910 Issued in CT

Practice address

800 Howard Ave
Yale Physicians Building
New Haven, CT 06519-1369

Phone

(203) 785-2140

Fax

(203) 785-6414

NPI assigned

Nov 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in RI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment NPD
• The Miriam Hospital

  • Cardiovascular Disease Physician
  • Providence, RI
  • NPI 1851677470
  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD
• The Miriam Hospital

  • Cardiac Rehabilitation Clinic/Center
  • East Greenwich, RI
  • NPI 1518482389
  NPD
• The Miriam Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1770520462
  NPD
• The Miriam Hospital

  • Adult Medicine Physician
  • Providence, RI
  • NPI 1831362813
  NPD

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1063495497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GEORGE ST",
            "address_2": "6TH FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116624",
            "telephone_number": "203-785-7998",
            "fax_number": "203-785-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE",
            "address_2": "YALE PHYSICIANS BUILDING",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-785-2140",
            "fax_number": "203-785-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "RAYMOND",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "038910",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CT",
            "license": "038910",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001389106",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David S Russell, M.D., PH.D.
• Dawn S Russell, M.D.
• Elizabeth G Russell, LCSW
• Jacqueline A Russell, LMSW
• Kerry S Russell, MD
• Sage Russell
• Mark B Russi, MD
• Paul Edward Russo Jr., M.D.
• Lauren Katharine Ruth, PH.D.
• Katherine Presley Rutland, APRN

• Cardiovascular Disease Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Cardiovascular Disease Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.