Active NPI
Russell D. Schroeder, M.D.
- Diagnostic Radiology Physician
- Odessa, TX
National Provider Identifier
1346274859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- J6720
- Practice address
- 500 W 4TH St
Odessa, TX 79761-5001 - Phone
- (432) 640-1273
- Fax
- (432) 640-4606
- NPI assigned
- Jul 10, 2006
- Last updated
- Jan 10, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | J6720 | TX | Primary |
| Vascular & Interventional Radiology Physician | 2085R0204X | J6720 | TX |
Addresses
Primary practice location
500 W 4TH St
Odessa, TX 79761-5001
Mailing address
PO Box 2129
Odessa, TX 79760-2129
Phone (432) 640-2408
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 167019204 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Texas Tech University Health Science Center School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
500 W 4TH St
Odessa, TX 79761-5001
Phone (432) 640-2401
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.41 of 100
- Quality
- 72.52
- Improvement activities
- 40
- Cost
- 81.49
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J6720 | TX | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCH Professional Care Hospital Based | Diagnostic Radiology | Current | Accepting new patients |
| Radcare of Texas PLLC | Diagnostic Radiology | Past | Accepting new patients |
| MCH Professional Care Radiology | Diagnostic Radiology | Past | Accepting new patients |
Locations
500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Odessa, TX
- NPI 1447547773
Diagnostic Radiology
-
dba ProCare
- Diagnostic Radiology Physician
- Odessa, TX
- NPI 1578674974
-
- Diagnostic Radiology Physician
- Fort Worth, TX
- NPI 1164470845
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba MCH Family Health Clinic
- Federally Qualified Health Center (FQHC)
- Odessa, TX
- NPI 1578265302
Hospital
-
dba Medical Center Hospital
- General Acute Care Hospital
- Odessa, TX
- NPI 1740273994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357776000000",
"number": "1346274859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2129",
"city": "ODESSA",
"state": "TX",
"postal_code": "797602129",
"telephone_number": "432-640-2408",
"fax_number": "432-640-4606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W 4TH ST",
"city": "ODESSA",
"state": "TX",
"postal_code": "797615001",
"telephone_number": "432-640-1273",
"fax_number": "432-640-4606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "RUSSELL",
"middle_name": "D.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2013-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "J6720",
"primary": true
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "TX",
"license": "J6720",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "167019204",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Odessa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.