Individual provider Active NPI

Conrad E Russell, CRNA

  • Certified Registered Nurse Anesthetist
  • Clearwater, FL
National Provider Identifier
1346410685
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9270911 Issued in FL
Practice address
300 Pinellas St
Clearwater, FL 33756-3804
Phone
(727) 462-7000
NPI assigned
Mar 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP9270911 FL Primary

Addresses

Primary practice location

300 Pinellas St
Clearwater, FL 33756-3804

Mailing address

300 Jeffords St
Suite B
Clearwater, FL 33756-3810
Phone (727) 441-1524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131118000001 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305912163 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Canton-Potsdam HospitalGroup PAC ID 6204827280, 243 clinicians

Practice addresses (Care Compare)

50 Leroy St
Potsdam, NY 13676-1786
Phone (315) 265-3300

Hospital & facility affiliations

  • Canton-Potsdam Hospital Hospital, Potsdam, NY, CCN 330197

Merit-based Incentive Payment System (MIPS)

Final score
98.56 of 100Reported as apm
Quality
87.76
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.56 of 100Reported as apm
Quality
87.76
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Canton-Potsdam Hospital CurrentSince May 19, 2014 Accepting new patients
Canton-Potsdam Hospital CurrentSince May 19, 2014 Accepting new patients
Gouverneur Hospital CurrentSince Feb 1, 2024 Accepting new patients
Gouverneur Hospital CurrentSince Feb 1, 2024 Accepting new patients
North Pinellas Anesthesia Associates, PA Nurse Anesthetist, Certified Registered PastSince May 7, 2023 Accepting new patients
Anesthesia Associates of Pinellas County Past Accepting new patients
Clearwater Pain Management Associates Past Accepting new patients

Locations

77 W Barney St
Gouverneur, NY 13642
Phone (315) 287-1000

1 Hospital Dr
Massena, NY 13662
Phone (315) 764-1711

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

Organizations & group practices 7

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 1

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": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1346410685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 JEFFORDS ST",
            "address_2": "SUITE B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563810",
            "telephone_number": "727-441-1524",
            "fax_number": "727-443-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PINELLAS ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563804",
            "telephone_number": "727-462-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CONRAD",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9270911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.