Individual provider Active NPI

Christina Patricia Russell, MD

  • Pediatrics Physician
  • Maple Grove, MN
National Provider Identifier
1255659538
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
56417 Issued in MN
Practice address
9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone
(763) 581-1000
NPI assigned
May 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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 56417 MN Primary

Addresses

Primary practice location

9875 Hospital Dr
Maple Grove, MN 55369-4648

Mailing address

16600 92ND Ave N Apt 337
Maple Grove, MN 55311-5455
Phone (612) 867-1689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20130619000495 MN Practitioner - Pediatric Medicine 7012156219 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56417MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jun 1, 2013 Accepting new patients
Fairview Bethesda Hospital CurrentSince Apr 1, 2020 Accepting new patients
Healtheast Care System CurrentSince Apr 1, 2020 Accepting new patients
Healtheast St. John'S Hospital CurrentSince Apr 1, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Apr 1, 2020 Accepting new patients
Fairview Health Services CurrentSince Jun 1, 2013 Accepting new patients
Fairview Clinics Current Accepting new patients
University of Minnesota Physicians CurrentSince Jun 15, 2022 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 1, 2020 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Apr 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Apr 1, 2020 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: crussell101154@fairview.direct-ci.com

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1255659538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16600 92ND AVE N APT 337",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553115455",
            "telephone_number": "612-867-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9875 HOSPITAL DR",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694648",
            "telephone_number": "763-581-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CHRISTINA",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "56417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.