NPIMap

Individual provider Active NPI

Richard B Russell, D.O.

  • Family Medicine Physician
  • Pine Grove, PA
National Provider Identifier
1144213240
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS004201L Issued in PA
Practice address
121 N Tulpehocken St
Pine Grove, PA 17963-1217
Phone
(570) 345-2345
Fax
(570) 345-2350
NPI assigned
Aug 24, 2005
Last updated
Nov 1, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS004201L PA Primary

Addresses

Primary practice location

121 N Tulpehocken St
Pine Grove, PA 17963-1217

Mailing address

121 N Tulpehocken St
Pine Grove, PA 17963-1217
Phone (570) 345-2345

Other identifiers 1

IdentifierTypeStateIssuer
0007538350005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040414001533 PA Practitioner - Family Practice 4981698560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

121 S Tulpehocken St
LVPG Family Medicine Pine Grove
Pine Grove, PA 17963-1011
Phone (570) 345-2345

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

200 Schuylkill Medical PLZ
Pottsville, PA 17901-3660
Phone (570) 621-9270

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.64 of 100Reported as group
Quality
76.75
Promoting interoperability
87
Improvement activities
40
Cost
74.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS004201LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schuylkill Health System Medical Group, Inc. Family Medicine CurrentSince Sep 15, 2014 Accepting new patients
Lehigh Valley Physician Group Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Lehigh Valley Physician Group Family Medicine Current Accepting new patients
Schuylkill Health System Medical Group, Inc. Family Medicine CurrentSince Sep 15, 2014 Accepting new patients
Lehigh Valley Physician Group Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

121 N Tulpehocken St
Pine Grove, PA 17963
Phone (570) 345-2345

205 E Laurel Blvd
Pottsville, PA 17901
Phone (570) 622-1887

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

Organizations & group practices 7

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 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1144213240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N TULPEHOCKEN ST",
            "city": "PINE GROVE",
            "state": "PA",
            "postal_code": "179631217",
            "telephone_number": "570-345-2345",
            "fax_number": "570-345-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N TULPEHOCKEN ST",
            "city": "PINE GROVE",
            "state": "PA",
            "postal_code": "179631217",
            "telephone_number": "570-345-2345",
            "fax_number": "570-345-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "RICHARD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS004201L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007538350005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Grove, PA

Sources for this page

Verify at the official NPI Registry.