NPIMap

Individual provider Active NPI

Russell Dylan Purpura, MD

  • Pulmonary Disease Physician
  • Indianapolis, IN
National Provider Identifier
1083144588
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
U3329 Issued in TX
Practice address
1120 W Michigan St # Cl630
Indianapolis, IN 46202-5209
Phone
(317) 278-2686
NPI assigned
Jun 16, 2017
Last updated
May 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11019509A IN
Pulmonary Disease Physician 207RP1001X U3329 TX Primary

Addresses

Primary practice location

1120 W Michigan St # Cl630
Indianapolis, IN 46202-5209

Mailing address

4458 Medical Dr Ste 505
San Antonio, TX 78229-3748
Phone (210) 690-7400

Other practice location 1

4458 Medical Dr Ste 505
San Antonio, TX 78229-3748
Phone (210) 690-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230523000619 TX Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 4688943566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
University of Texas Medical Branch at Galveston, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Ips LLCGroup PAC ID 9638356801, 44 clinicians

Practice addresses (Care Compare)

4458 Medical Dr
Suite 505
San Antonio, TX 78229-3748
Phone (210) 690-7400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
U3329TXMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ips LLC Pulmonary Disease CurrentSince Mar 1, 2023 Accepting new patients
The Metrohealth System Current Accepting new patients

Locations

34910 Interstate 10 W
Ste 601
Boerne, TX 78006
Phone (830) 248-1207

1434 E Sonterra Blvd
Ste 210
San Antonio, TX 78258
Phone (210) 481-3119

4458 Medical Dr
Ste 505
San Antonio, TX 78229

4499 Medical Dr
#150
San Antonio, TX 78229
Phone (210) 614-8181

Interoperability endpoints

  • Direct secure messaging: rpurpura206499@direct.metrohealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1497571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1083144588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4458 MEDICAL DR STE 505",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293748",
            "telephone_number": "210-690-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W MICHIGAN ST # CL630",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "317-278-2686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4458 Medical Dr Ste 505",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293748",
            "country_code": "US",
            "telephone_number": "210-690-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PURPURA",
        "first_name": "RUSSELL",
        "middle_name": "DYLAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-16",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11019509A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "U3329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.