Kamal B Russell, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD025132E Issued in PA

Practice address

39 Sleepy Hollow Dr
Newtown Square, PA 19073

Phone

(610) 359-9191

Fax

(610) 359-9292

NPI assigned

Jan 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Kamal B. Russell MD PC

  • Nuclear Radiology Physician
  • Media, PA
  • NPI 1356398234

  Diagnostic Radiology

  NPD (past) Authorized official
• Riddle Imaging Assoc

  • Diagnostic Radiology Physician
  • Media, PA
  • NPI 1013073469
  NPD (past) Authorized official

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1124007950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 SLEEPY HOLLOW DR",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733929",
            "telephone_number": "610-359-9191",
            "fax_number": "610-359-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 SLEEPY HOLLOW DR",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "19073",
            "telephone_number": "610-359-9191",
            "fax_number": "610-359-9292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1068 W Baltimore Pike",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "19063",
            "country_code": "US",
            "telephone_number": "610-891-3388",
            "fax_number": "610-891-3680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KAMAL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD025132E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099357302",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harold Russell Romesburg, DDS
• Kimberly Roncase
• Royal Home Care Agency, LLC
• Megan Lee Rupp, MS
• Erica C Rushing, M.D.
• Laura Ann Russo-Innamorato, PSYD
• Tareah Ryant, CRNP
• Rosalma Saade, M.D.
• Sacred Hearts Counseling Services, LLC
• Sage Counseling LLC

• Diagnostic Radiology Physician in Newtown Square, PA
• Providers in Newtown Square, PA by specialty
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.