Gabriel Russell, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003277 Issued in GA

Practice address

1044 Avalon Pkwy
McDonough, GA 30253-7661

Phone

(770) 898-7078

Fax

(770) 898-7160

NPI assigned

Jul 27, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, GA2 enrollments

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 2

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Onsite 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vision Onsite

  • Optometrist
  • Acworth, GA
  • NPI 1962238931

  GA, Optometrist

  Medicare reassignment Care Compare group NPD
• Arnand Comprehensive Eye Care LLC

  • Primary Care Clinic/Center
  • Morrow, GA
  • NPI 1235704651

  GA

  Medicare reassignment Authorized official
• Ga Doctors of Optometry LLC

  • Optometrist
  • Lithonia, GA
  • NPI 1174105936

  GA, Optometrist

  Medicare reassignment NPD
• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Rincon, GA
  • NPI 1437294592

  GA, Optometrist

  Medicare reassignment NPD
• Bistline Vision Care Associates, PC

  • Optometrist
  • Plymouth Meeting, PA
  • NPI 1972882942

  PA

  Medicare reassignment
• Eyecontact Inc.

  • Optometrist
  • Acworth, GA
  • NPI 1407054232
  NPD
• Ga Doctors of Optometry LLC

  • Eyewear Supplier
  • Columbus, GA
  • NPI 1013599745

  Optometrist

  NPD
• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Tyrone, GA
  • NPI 1275326571
  NPD
• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • McDonough, GA
  • NPI 1790288850
  NPD
• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Woodstock, GA
  • NPI 1144684184
  NPD (past)

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1306323779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 AVALON PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537661",
            "telephone_number": "770-898-7078",
            "fax_number": "770-898-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-27",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003277",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003445",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Royal Nursing & Training Institute
• Bernard A Royal Jr., APRN, FNP-C
• Kamesha Kallia Roye
• Della Taylor Royston, WOMENS HEALTH NP
• Stephanie L Rush, LPC
• Christa Russie, PHARM D
• Stephanie Ann Rytel-Smith, D.C
• Alicia C Saavedra Fant
• Sacred Journey Hospice, LLC
• Sacred Space Psychiatry Center LLC

• All providers in McDonough, GA
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.