Individual provider Active NPI

Shana M Russ, FNP

  • Acute Care Nurse Practitioner
  • Geneva, NY
National Provider Identifier
1164734695
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
336385 Issued in NY
Practice address
196 North St
Geneva, NY 14456-1651
Phone
(315) 787-4500
NPI assigned
Jul 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 336385 NY Primary

Addresses

Primary practice location

196 North St
Geneva, NY 14456-1651

Mailing address

196 North St
Geneva, NY 14456-1651
Phone (315) 787-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101028000784 NY Practitioner - Nurse Practitioner 6103010681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geneva General Hospital, IncGroup PAC ID 7810809407, 88 clinicians

Practice addresses (Care Compare)

196 198 N St
Geneva, NY 14456-1694
Phone (315) 789-4222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
336385NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geneva General Hospital, Inc CurrentSince Jul 19, 2010 Accepting new patients
Geneva General Hospital, Inc Current Accepting new patients
Geneva General Hospital CurrentSince Jul 19, 2010 Accepting new patients

Locations

196 North St
Geneva, NY 14456
Phone (315) 787-4156

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1164734695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 NORTH ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561651",
            "telephone_number": "315-787-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 NORTH ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561651",
            "telephone_number": "315-787-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "SHANA",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "336385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

Verify at the official NPI Registry.