Individual provider Active NPI

Penelop Russell

  • Case Manager/Care Coordinator
  • Brooklyn, NY
National Provider Identifier
1245128552
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
493 E 93Rd St
Brooklyn, NY 11212-1661
Phone
(917) 202-3930
NPI assigned
Jun 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

493 E 93Rd St
Brooklyn, NY 11212-1661

Mailing address

493 E 93Rd St
Brooklyn, NY 11212-1661
Phone (917) 202-3930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1245128552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 E 93RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112121661",
            "telephone_number": "917-202-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 E 93RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112121661",
            "telephone_number": "917-202-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "PENELOP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.