Individual provider Active NPI

Russell Lee Harral III, MD

  • Ophthalmology Physician
  • Jonesboro, AR
National Provider Identifier
1215968425
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C8264 Issued in AR
Practice address
623 E Matthews Ave
Jonesboro, AR 72401-3145
Phone
(870) 932-2211
Fax
(870) 972-5152
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X C8264 AR Primary

Addresses

Primary practice location

623 E Matthews Ave
Jonesboro, AR 72401-3145

Mailing address

623 E Matthews Ave
Jonesboro, AR 72401-3145
Phone (870) 932-2211

Other identifiers 1

IdentifierTypeStateIssuer
131208001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20100803000235 AR Practitioner - Ophthalmology 5991783409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Arkansas College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Care Center of Northeast Arkansas LLCGroup PAC ID 2860470374, 8 clinicians

Practice addresses (Care Compare)

623 E Matthews Ave
Jonesboro, AR 72401-3145

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.22 of 100Reported as group
Quality
98.17
Improvement activities
40
Cost
76.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery514

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C8264ARMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Care Center of Northeast Arkansas LLC Ophthalmology CurrentSince Jun 1, 1999 Accepting new patients
Jonesboro Surgery Center Anesthesia Current Accepting new patients

Locations

623 E Matthews Ave
Ste A
Jonesboro, AR 72401
Phone (870) 932-2211

623 E Matthews Ave
Ste C
Jonesboro, AR 72401
Phone (870) 932-2211

623 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 536-4100

Organizations & group practices 2

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 1

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1215968425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013145",
            "telephone_number": "870-932-2211",
            "fax_number": "870-972-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013145",
            "telephone_number": "870-932-2211",
            "fax_number": "870-972-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRAL",
        "first_name": "RUSSELL",
        "middle_name": "LEE",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AR",
            "license": "C8264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131208001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.