Daric J Russell, DO

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

0-1036 Issued in ID

Practice address

3385 Potomac Way
Idaho Falls, ID 83404-4978

Phone

(208) 522-7246

Fax

(208) 529-2620

NPI assigned

May 18, 2012

Last updated

Jan 6, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in ID, MT2 enrollments

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 2

Specialty

Pain ManagementAlso: Osteopathic Manipulative Medicine

Education

Arizona College of Osteopathic Medicine Mid Western University, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
• Madison Memorial Hospital Hospital, Rexburg, ID, CCN 130025
• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
• Teton Valley Hospital Hospital, Driggs, ID, CCN 131313

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Medicare reassignment Care Compare group NPD
• North Canyon Medical Center Inc.

  dba North Canyon Medical Center

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1609046671
  Medicare reassignment NPD
• Teton Valley Health Care Inc

  dba Teton Valley Health Care

  • Critical Access Hospital
  • Driggs, ID
  • NPI 1477809622
  Medicare reassignment NPD
• Marcus Daly Memorial Hospital Corporation

  dba Bitterroot Health - Daly Hospital

  • Critical Access Hospital
  • Hamilton, MT
  • NPI 1659475846
  Medicare reassignment NPD
• North Canyon Medical Center, Inc.

  dba North Canyon Family Medicine

  • Rural Health Clinic/Center
  • Gooding, ID
  • NPI 1518377019
  NPD
• North Canyon Medical Center, Inc.

  dba North Canyon Imaging Center Twin Falls

  • Radiology Clinic/Center
  • Twin Falls, ID
  • NPI 1700641636
  NPD
• Marcus Daly Memorial Hospital Corporation

  dba Bitterroot Health - Nephrology

  • Nephrology Physician
  • Hamilton, MT
  • NPI 1235997958
  NPD
• Medical Imaging Associates of Idaho Falls, Inc

  • Diagnostic Radiology Physician
  • Pocatello, ID
  • NPI 1740225531
  NPD (past)
• Mountain View Hospital Physician Organization

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1073834529
  NPD (past)

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

• Eastern Idaho Health Services Inc

  dba Eastern Idaho Regional Medical Center

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation
• Madison Co Memorial Hospital

  dba Seasons Medical By Madison Memorial

  • Obstetrics & Gynecology Physician
  • Rexburg, ID
  • NPI 1073154266

  Hospital

  Care Compare affiliation
• Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
  • NPI 1992747570
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• Teton Valley Health Care Inc

  dba Teton Valley Health Care

  • Critical Access Hospital
  • Driggs, ID
  • NPI 1477809622
  Care Compare affiliation

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1154681633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3385 POTOMAC WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044978",
            "telephone_number": "208-522-7246",
            "fax_number": "208-529-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 POTOMAC WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044978",
            "telephone_number": "208-522-7246",
            "fax_number": "208-529-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DARIC",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-18",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "ID",
            "license": "0-1036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Ruhnau
• Anna Ruiz-Gruwell, NP-C
• Brooke Sue Rupe, COTA/L
• Michael Rupp
• Russell Guymon Orthodontics, PA
• Sarah Lynn Russell, BSW, LMSW
• Lisa J Russom, LSW
• Orin Kelley Ryan, DPT
• Rhonda Ryan, L.M.T.
• S. Albertson Dermatology and Skin Cancer Center LLC

• Pain Medicine (Anesthesiology) Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Pain Medicine (Anesthesiology) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.