Carol Mae Russell, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

238185 Issued in NY

Practice address

1 Bay Ave
Montclair, NJ 07042-4837

Phone

(973) 429-6000

Fax

(973) 429-6209

NPI assigned

Jan 8, 2007

Last updated

Feb 20, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, NJ, NC3 enrollments

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 3

Specialty

Obstetrics/Gynecology

Education

New York College of Osteo Medicine of New York Institute of Technology, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: carol.russell.1@26576.direct.athenahealth.com
• Direct secure messaging: carol.russell.1@7773.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/13669/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Practice Associates Medical Group

  dba Atlantic Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• DHP of New Jersey PA

  • Obstetrics & Gynecology Physician
  • Edison, NJ
  • NPI 1275896516
  Medicare reassignment NPD
• Neighborhood Health Services Corporation

  dba Neighborhood Health Center - Phillipsburg

  • Federally Qualified Health Center (FQHC)
  • Phillipsburg, NJ
  • NPI 1003850488
  Medicare reassignment NPD
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Obstetrics & Gynecology

  Medicare reassignment NPD
• OB Hospitalist Services New Jersey, PA

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1801169966

  NJ

  Medicare reassignment NPD
• Uwh of the Carolinas, PLLC

  • Obstetrics & Gynecology Physician
  • Morrisville, NC
  • NPI 1639506470
  Medicare reassignment NPD
• Neighborhood Health Services Corporation

  dba Neighborhood Health Center - Elizabeth

  • Federally Qualified Health Center (FQHC)
  • Elizabeth, NJ
  • NPI 1538383666
  NPD
• Ahs Hospital Corp.

  dba Overlook Hospital

  • General Acute Care Hospital
  • Summit, NJ
  • NPI 1740254143
  NPD (past)
• Amboy Medical Practice PC

  • Diagnostic Radiology Physician
  • Staten Island, NY
  • NPI 1104692672
  NPD (past)
• Amboy Medical Practice PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1700037975

  Obstetrics & Gynecology

  NPD (past)
• Beacon Christian Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Staten Island, NY
  • NPI 1639246358

  Obstetrics & Gynecology

  NPD (past)
• Richmond University Medical Center

  • Multi-Specialty Clinic/Center
  • Staten Island, NY
  • NPI 1811054042
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1265580096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 OLD HOOK RD",
            "address_2": "2ND FLOOR",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301381",
            "telephone_number": "201-666-3900",
            "fax_number": "201-261-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6000",
            "fax_number": "973-429-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CAROL",
        "middle_name": "MAE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "238185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02832057",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hadley A Rubino, D.M.D.
• Alena Ruble-Albar, RPH
• Roxanne Ruiz-Adams, DSW, LCSW
• Patricia Maria Ruiz, RN, APN
• Edmund John Rung Jr., LCSW
• Patrick Kelly Russell, DNAP, CRNA
• Samantha Russomano, RDN
• Beshoy Saad, PHARMD
• Michelle Sabatini, APNC, RN, PHD
• Akwete Sackey, D.C

• Obstetrics & Gynecology Physician in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.