Individual provider Active NPI

Linda Gail Russek, PH.D.

  • Clinical Psychologist
  • Tucson, AZ
National Provider Identifier
1225185580
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3524 Issued in AZ
Practice address
5440 N Airway Dr
Tucson, AZ 85750-9627
Phone
(520) 749-4042
Fax
(520) 749-2481
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3524 AZ Primary

Addresses

Primary practice location

5440 N Airway Dr
Tucson, AZ 85750-9627

Mailing address

5440 N Airway Dr
Tucson, AZ 85750-9627
Phone (520) 749-4042

Other identifiers 2

IdentifierTypeStateIssuer
340351OtherAZMHN
0617840OtherAZBCBSAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051108000710 AZ Practitioner - Clinical Psychologist 7517985583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5440 N Airway Dr
Tucson, AZ 85750-9627
Phone (520) 749-4042

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3524AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Science Inc Clinical CurrentSince Jan 31, 2011 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225185580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 N AIRWAY DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857509627",
            "telephone_number": "520-749-4042",
            "fax_number": "520-749-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 N AIRWAY DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857509627",
            "telephone_number": "520-749-4042",
            "fax_number": "520-749-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSEK",
        "first_name": "LINDA",
        "middle_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "340351",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAZ",
            "identifier": "0617840",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.