Andrea Nicole Russell, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG002367 Issued in PA

Practice address

428 Windmere Dr
Suite 100
State College, PA 16801-7644

Phone

(814) 234-2015

Fax

(814) 238-5300

NPI assigned

Jul 15, 2010

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

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nittany Eye Associates LTDGroup PAC ID 4688740855, 11 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: arussell@direct.revolutionehr.com

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.

• Nittany Eye Associates LTD

  • Optometrist
  • State College, PA
  • NPI 1619071131
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1295048536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 WINDMERE DR",
            "address_2": "SUITE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017644",
            "telephone_number": "814-234-2015",
            "fax_number": "814-238-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 WINDMERE DR",
            "address_2": "SUITE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017644",
            "telephone_number": "814-234-2015",
            "fax_number": "814-238-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ANDREA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory A Ruff, M.D.
• Jennifer Ruffaner
• Michelle Lynn Ruffo, DPT
• Erica Rulon, CRNP, FNP-C
• Joanna Ruppa
• Anni Russo, PT
• Elizabeth Mae Ryan
• Sarah Xiao Ryan, PA-C
• Allison Marie Saal, PA-C
• Diljot Singh Sachdeva, PSY.D.

• Optometrist in State College, PA
• Providers in State College, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.