Nathan E Russell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

59940 Issued in AZ

Practice address

37100 N Gantzel Rd Ste 201a
San Tan Valley, AZ 85140-7352

Phone

(480) 394-4469

NPI assigned

Apr 17, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

87.28 of 100Reported as group

Quality

83.84

Promoting interoperability

100

Improvement activities

40

Cost

73.75

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nathan.russell@bannerhealth.com

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.

• Nathan Russell, MD, PLLC

  • Family Medicine Physician
  • Queen Creek, AZ
  • NPI 1346184868
  NPD Authorized official

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1205360237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37100 N GANTZEL RD STE 201A",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407352",
            "telephone_number": "480-394-4469",
            "fax_number": "480-394-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37100 N GANTZEL RD STE 201A",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407352",
            "telephone_number": "480-394-4469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "527 Medical Park Dr",
            "address_2": "Suite 500",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "WV",
            "postal_code": "263309008",
            "country_code": "US",
            "telephone_number": "681-342-3600",
            "fax_number": "681-342-3625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37000 N Gantzel Rd",
            "address_purpose": "LOCATION",
            "city": "San Tan Valley",
            "state": "AZ",
            "postal_code": "851407303",
            "country_code": "US",
            "telephone_number": "480-394-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6644 E Baywood Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852061797",
            "country_code": "US",
            "telephone_number": "480-321-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "NATHAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-17",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "59940",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "59940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nathan.Russell@BannerHealth.com",
            "affiliation": "Y",
            "endpointDescription": "Work Email",
            "affiliationName": "Banner Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "37100 N Gantzel Rd Ste 201A",
            "city": "San Tan Valley",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "851407352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.