Active NPI
Adam John Russ, O.D.
- Optometrist
- Evansville, IN
National Provider Identifier
1063728657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18003640A
- Practice address
- 562 S Green River Rd
Evansville, IN 47715-7308 - Phone
- (812) 479-5208
- Fax
- (812) 471-0486
- NPI assigned
- Aug 20, 2010
- Last updated
- Apr 15, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18003640A | IN | Primary |
Addresses
Primary practice location
562 S Green River Rd
Evansville, IN 47715-7308
Mailing address
562 S Green River Rd
Evansville, IN 47715-7308
Phone (812) 479-5208
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201046070 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
562 S Green River Rd
Evansville, IN 47715-7308
Phone (812) 479-5208
Merit-based Incentive Payment System (MIPS)
- Final score
- 59.88 of 100
- Quality
- 29.24
- Promoting interoperability
- 96
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 17 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18003640A | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Eye Consultants, P.C. | Optometrist | Past | Accepting new patients |
| Adam J Russ OD LLC | Optometrist | Past | Accepting new patients |
| Midwest Eye Consultants, PC | Optometrist | Past | Accepting new patients |
Interoperability endpoints
- drruss@ridgwayeyecare.direct.eyemdemr.com
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.
-
- Optometrist
- Evansville, IN
- NPI 1689725111
-
- Optometrist
- Evansville, IN
- NPI 1063765659
-
dba Midwest Eye Consultants #12
- Optometrist
- Greensburg, IN
- NPI 1013480482
-
dba Cataract and Laser FW - Wayne
- Optometrist
- Fort Wayne, IN
- NPI 1548132715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744675200000",
"number": "1063728657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "562 S GREEN RIVER RD",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477157308",
"telephone_number": "812-479-5208",
"fax_number": "812-471-0486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "562 S GREEN RIVER RD",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477157308",
"telephone_number": "812-479-5208",
"fax_number": "812-471-0486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSS",
"first_name": "ADAM",
"middle_name": "JOHN",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-20",
"last_updated": "2025-04-15",
"certification_date": "2025-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18003640A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201046070",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.