Will Thomas Russell, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS015414 Issued in PA

Practice address

206 E Brown St
East Stroudsburg, PA 18301-3094

Phone

(570) 476-3353

NPI assigned

Jun 27, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Emergency Physician Associates of Pennsylvania, PC

  • Emergency Medicine Physician
  • Hanover, PA
  • NPI 1619990900
  Medicare reassignment NPD
• Emergency Care Services of Pennsylvania, P.C.

  • Emergency Medicine Physician
  • Wilkes Barre, PA
  • NPI 1235374927
  NPD (past)
• Pocono Emergency Physicians, P.C.

  • Emergency Medicine Physician
  • East Stroudsburg, PA
  • NPI 1700832151
  NPD (past)

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1124280490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 SCHOENERSVILLE RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177300",
            "telephone_number": "484-884-2888",
            "fax_number": "484-884-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 E BROWN ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013094",
            "telephone_number": "570-476-3353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2545 Schoenersville Rd",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180177300",
            "country_code": "US",
            "telephone_number": "484-884-2888",
            "fax_number": "484-884-2885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "WILL",
        "middle_name": "THOMAS",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT012329",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS015414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0483923",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Royal Bloom Home Care Inc
• Gerard D. Rozea, PHD
• Susan Mara Rubin
• Alyssa Sue Ruggiero, SLP
• Donald B Rush, OD
• Abby Rustay, PA-C
• Abigail Rustic
• Darya Rybac, CRNP
• Patricia A Rylko, M.D.
• Rene Ellen Rymar, PA-C

• Emergency Medicine Physician in East Stroudsburg, PA
• Providers in East Stroudsburg, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.