Scott Russell, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

12138 Issued in CA

Practice address

41120 Washington St Ste 201
Bermuda Dunes, CA 92203-9596

Phone

(760) 360-3193

Fax

(760) 360-3194

NPI assigned

Mar 14, 2006

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Internal Medicine

Education

University of North Texas HSC, College of Osteopathic Med, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles (3 of 4)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: scott.russell.p75@direct.mydohc.nextgenshare.com

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.

• Scott Russell DO Inc

  • Clinic/Center
  • Bermuda Dunes, CA
  • NPI 1144919911

  CA

  Medicare reassignment NPD Authorized official
• Desert Medical Group, Inc.

  • Family Medicine Physician
  • Palm Springs, CA
  • NPI 1114918612

  CA, Internal Medicine

  Medicare reassignment NPD
• Coastal Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Lucedale, MS
  • NPI 1427842913
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1073581237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41120 WASHINGTON ST STE 201",
            "city": "BERMUDA DUNES",
            "state": "CA",
            "postal_code": "922039596",
            "telephone_number": "760-360-3193",
            "fax_number": "760-360-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41120 WASHINGTON ST STE 201",
            "city": "BERMUDA DUNES",
            "state": "CA",
            "postal_code": "922039596",
            "telephone_number": "760-360-3193",
            "fax_number": "760-360-3194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SCOTT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "12138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrick Wayne Raburn, PT
• Ralphs Grocery Company
• Edward Anthony Ramirez
• Janet Lee Roberts, M.D.
• Brandon Rosi, PT, DPT, CSCS
• Scott Russell DO Inc
• Isai Serrano, LCSW
• Mark Shabashov, RPH
• Arif J Shaikh, M.D.
• Maridy Sherrill

• All providers in Bermuda Dunes, CA
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.