Individual provider Active NPI

Elsa Russom, M.D.

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1336589704
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
270589-1 Issued in NY
Practice address
506 6TH Street
Brooklyn, NY 11215
Phone
(718) 780-3775
Fax
(718) 780-3774
NPI assigned
Jul 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X CT52443 CT
Psychiatry Physician 2084P0800X 270589-1 NY Primary

Addresses

Primary practice location

506 6TH Street
Brooklyn, NY 11215

Mailing address

506 6TH Street
Brooklyn, NY 11215
Phone (718) 780-3775

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address elr9102@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX, NM3 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

Enrollment IDStateProvider typePAC IDDetails
I20150408000689 NY Practitioner - Psychiatry 4587748496 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY
I20240318003767 TX Practitioner - Psychiatry 4587748496 Reassigns benefits to 1 organization
I20260422002346 NM Practitioner - Psychiatry 4587748496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindcare Solutions of Texas, P.a.Group PAC ID 5597173088, 8 clinicians
Kings Physician Services PCGroup PAC ID 0547579427, 643 clinicians

Practice addresses (Care Compare)

101 Posey Ave
Clifton, TX 76634-1289
Phone (330) 536-3746

2000 Scenic Dr
Georgetown, TX 78626-7726
Phone (330) 536-3746

2400 Round Rock Ave
Round Rock, TX 78681-4004
Phone (330) 536-3746

506 6TH St
Brooklyn, NY 11215-3609
Phone (718) 780-3000

901 W Ben White Blvd
Austin, TX 78704-6903
Phone (330) 536-3746

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.47 of 100Reported as group
Quality
84.67
Promoting interoperability
100
Improvement activities
40
Cost
71.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CT52443CTMDPsychiatry Physician
270589-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC CurrentSince Sep 1, 2016 Accepting new patients
Russom Psychiatry, PLLC CurrentSince Apr 20, 2025 Accepting new patients
Kings Physician Services, PC CurrentSince Sep 1, 2016 Accepting new patients
Mindcare Solutions of Texas PA Psychiatry CurrentSince Feb 5, 2024 Accepting new patients
Vip Home Health Care Agency PastSince Nov 16, 2007 Accepting new patients

Locations

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

4031 Aspen Grove Dr
Ste 390
Franklin, TN 37067
Phone (844) 291-4525

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

101 S Avenue T
Clifton, TX 76634
Phone (254) 675-8322

10864 Texas Health Trl
Fort Worth, TX 76244
Phone (682) 212-2000

Networks

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

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1336589704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 6TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "718-780-3775",
            "fax_number": "718-780-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "718-780-3775",
            "fax_number": "718-780-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSOM",
        "first_name": "ELSA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "CT52443",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "270589-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "506 6th Street",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "506 6th Street",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elr9102@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Messaging",
            "address_1": "506 6th Street",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.