Individual provider Active NPI

Adam John Russ, O.D.

  • Optometrist
  • Evansville, IN
National Provider Identifier
1063728657
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003640A Issued in IN
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, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
201046070MedicaidIN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120203000075 IN Practitioner - Optometry 8426215476 Reassigns benefits to 1 organization

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
Ridgway Eyecare Center P CGroup PAC ID 6305904012, 2 clinicians

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 100Reported as group
Quality
29.24
Promoting interoperability
96
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18003640AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Adam J Russ OD LLC Optometrist PastSince Oct 11, 2014 Accepting new patients
Midwest Eye Consultants, PC Optometrist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.