Alex Russakovsky, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4635 Issued in MA

Practice address

22 McGrath Hwy
Pearle Vision
Somerville, MA 02143-4508

Phone

(617) 623-7522

NPI assigned

Aug 9, 2007

Sex

Male

Sole proprietor

Yes

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 MA

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

New England College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Twin City Eye, Inc.

  • Optometrist
  • Somerville, MA
  • NPI 1639447329
  Medicare reassignment NPD Authorized official
• Wilmington Eye Group, Inc.

  • Optometrist
  • Wilmington, MA
  • NPI 1003226879
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1366634792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MCGRATH HWY",
            "address_2": "# 4",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021434508",
            "telephone_number": "617-285-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MCGRATH HWY",
            "address_2": "PEARLE VISION",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021434508",
            "telephone_number": "617-623-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSAKOVSKY",
        "first_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glorimar Ruiz Mercado
• Osdual Miguel Ruiz Sr.
• Perla Ruiz, LPN
• Barry Rund
• Eileen P Rush
• Anna C Russell
• Ann S Rutherford, LICSW
• Kathleen Rutkin, CPD, CLC
• Ryan Hatlelid Counseling, LLC
• Mary Lou Ryan, RNCS

• Optometrist in Somerville, MA
• Providers in Somerville, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.