Individual provider Active NPI

Russell R McDonald, M.D.

  • Pediatrics Physician
  • Plano, TX
National Provider Identifier
1255333605
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
F1799 Issued in TX
Practice address
4001 W 15TH St Ste 350
Plano, TX 75093-5863
Phone
(972) 596-2131
Fax
(972) 867-3549
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X F1799 TX Primary

Addresses

Primary practice location

4001 W 15TH St Ste 350
Plano, TX 75093-5863

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200728003695 TX Practitioner - Pediatric Medicine 7911322623 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F1799TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Pediatrics CurrentSince Aug 17, 2020 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Aug 17, 2020 Accepting new patients

Locations

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

4001 W 15th St
Ste 300
Plano, TX 75093
Phone (214) 691-9777

4001 W 15th St
Ste 350
Plano, TX 75093
Phone (972) 596-2131

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

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.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1255333605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W 15TH ST STE 350",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935863",
            "telephone_number": "972-596-2131",
            "fax_number": "972-867-3549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "RUSSELL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "F1799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.