Individual provider Active NPI

Kristine Russell, CRNP

  • Acute Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1073786232
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R138506 Issued in MD
Practice address
22 S Greene St
Cardiac Surgery, N4W94
Baltimore, MD 21201-1544
Phone
(410) 328-5382
NPI assigned
Apr 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R138506 MD Primary

Addresses

Primary practice location

22 S Greene St
Cardiac Surgery, N4W94
Baltimore, MD 21201-1544

Mailing address

22 S Greene St
Cardiac Surgery, N4W94
Baltimore, MD 21201-1544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140724001892 MD Practitioner - Nurse Practitioner 0648430231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

419 W Redwood St
FL 3
Baltimore, MD 21201-1734
Phone (410) 328-5300

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R138506MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Surgical Associates, PA CurrentSince May 14, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
University of Maryland Surgcial Assoc PA Past Accepting new patients

Locations

419 W Redwood St
Ste 300
Baltimore, MD 21201
Phone (410) 328-5300

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

419 W Redwood St
Fl 3
Baltimore, MD 21201
Phone (410) 328-5300

22 S Greene St
#N4W94
Baltimore, MD 21201
Phone (410) 328-3822

Interoperability endpoints

  • Direct secure messaging: krussell17514@direct.umm.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1073786232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "address_2": "CARDIAC SURGERY, N4W94",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "address_2": "CARDIAC SURGERY, N4W94",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KRISTINE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R138506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.