L. Russell Pet, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

150723 Issued in MA

Practice address

4 Hartwell St Ste 1
Fall River, MA 02721-3019

Phone

(508) 675-0089

Fax

(508) 675-2233

NPI assigned

Jul 20, 2006

Last updated

Apr 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Psychiatry

Education

Warren Alpert Medical School of Brown University, 1992

Medicare assignment

May accept Medicare assignment

Group practices

Lifespan Physician Group of Massachusetts IncGroup PAC ID 3870020399, 458 clinicians

Lifespan of Massachusetts - Fall River IncGroup PAC ID 7214460278, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Anne's Hospital Hospital, Fall River, MA, CCN 220020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lpet20927@direct.southcoast.org

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.

• Lifespan of Massachusetts - Fall River Inc

  • Psychiatric Hospital Unit
  • Fall River, MA
  • NPI 1013744200

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group of Massachusetts Inc

  dba Brown Health Medical Group

  • Family Medicine Physician
  • Taunton, MA
  • NPI 1235957713

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Russell Pet M.D. Inc

  • Child & Adolescent Psychiatry Physician
  • Fall River, MA
  • NPI 1710204391
  Medicare reassignment NPD
• Southcoast Hospitals Group, Inc

  dba Charlton Memorial Hospital

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1306871223
  Medicare reassignment NPD
• Southcoast Physicians Group, Inc.

  • Family Medicine Physician
  • Fairhaven, MA
  • NPI 1336137629
  Medicare reassignment NPD
• Lifespan of Massachusetts - Fall River Inc

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1972330165

  Psychiatry

  NPD
• Southcoast Hospitals Group Inc

  dba Southcoast Pharmacy

  • Community/Retail Pharmacy
  • New Bedford, MA
  • NPI 1376565366
  NPD
• Southcoast Physicians Group, Inc.

  • Orthopaedic Surgery Physician
  • North Dartmouth, MA
  • NPI 1902201536
  NPD
• Steward St. Anne's Hospital Corporation

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1295027134

  Psychiatry

  NPD

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

• Lifespan of Massachusetts - Fall River Inc

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1972330165
  Care Compare affiliation

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1194745257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HARTWELL ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027213019",
            "telephone_number": "508-675-0089",
            "fax_number": "508-675-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HARTWELL ST STE 1",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027213019",
            "telephone_number": "508-675-0089",
            "fax_number": "508-675-2233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "363 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027203703",
            "country_code": "US",
            "telephone_number": "508-973-5930",
            "fax_number": "508-973-5931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PET",
        "first_name": "L. RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "150723",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "8850",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3154564",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpet20927@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "363 Highland Ave",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027203703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen Perry-Rose
• Nicole Perry
• Susan J Perry, NP
• Susan Jean Perry, APRN
• J. Bruno Pestana, M.D.
• Patricia Mateus Peterson, LICSW
• Tayla Petit
• Renee Allison Petrin
• Savannah Pettenati
• Heath C. Pettine

• Psychiatry Physician in Fall River, MA
• Providers in Fall River, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.