Active NPI
Russell Robert Deluca, M.D.
- Hematology & Oncology Physician
- Glen Burnie, MD
National Provider Identifier
1114994373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- D0031551
- Practice address
- 305 Hospital Drive
Glen Burnie, MD 21061 - Phone
- (410) 761-9896
- Fax
- (410) 761-2250
- NPI assigned
- Mar 7, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology (Internal Medicine) Physician | 207RH0000X | D0031551 | MD | |
| Hematology & Oncology Physician | 207RH0003X | D0031551 | MD | Primary |
Addresses
Primary practice location
305 Hospital Drive
Glen Burnie, MD 21061
Mailing address
305 Hospital Drive
Glen Burnie, MD 21061
Phone (410) 761-9896
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 408391100 | Medicaid | MD | |
| 210121100 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0031551 | MD | MD | Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645660800000",
"number": "1114994373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 HOSPITAL DRIVE",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "21061",
"telephone_number": "410-761-9896",
"fax_number": "410-761-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 HOSPITAL DRIVE",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "21061",
"telephone_number": "410-761-9896",
"fax_number": "410-761-2250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELUCA",
"first_name": "RUSSELL",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-07",
"last_updated": "2022-02-24",
"certification_date": "2022-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology",
"state": "MD",
"license": "D0031551",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "MD",
"license": "D0031551",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "408391100",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "210121100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glen Burnie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.