Active NPI
Ryan William Russell, D.O.
- Family Medicine Physician
- Arden Hills, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 67442
- Practice address
- 3930 Northwoods Dr
Arden Hills, MN 55112-6963 - Phone
- (651) 523-8500
- NPI assigned
- Apr 11, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 67442 | MN | Primary |
Addresses
Primary practice location
3930 Northwoods Dr
Arden Hills, MN 55112-6963
Mailing address
8170 33Rd Ave S
Bloomington, MN 55425-4516
Phone (651) 523-8500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- 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
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2945 Lincoln Dr
Roseville, MN 55113-1338
Phone (651) 631-6570
3930 Northwood Dr
Arden Hills, MN 55112-6963
Phone (651) 490-6700
Hospital & facility affiliations
- Healthpartners Hospice and Palliatice Care
- Regions Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67442 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Group Health, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients |
Locations
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600
8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
-
- Rehabilitation Clinic/Center
- Roseville, MN
- NPI 1801517230
-
- General Practice Dentistry
- Saint Paul, MN
- NPI 1952042053
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Community Based Hospice Care Agency
- Bloomington, MN
- NPI 1871534628
-
- General Acute Care Hospital
- Woodbury, MN
- NPI 1104681105
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1306873872
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1629006457
-
- General Acute Care Hospital
- Stillwater, MN
- NPI 1679391122
-
- General Acute Care Hospital
- Coon Rapids, MN
- NPI 1962149419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596412800000",
"number": "1366975906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516",
"telephone_number": "651-523-8500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3930 NORTHWOODS DR",
"city": "ARDEN HILLS",
"state": "MN",
"postal_code": "551126963",
"telephone_number": "651-523-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "RYAN",
"middle_name": "WILLIAM",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-11",
"last_updated": "2020-08-03",
"certification_date": "2020-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "67442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Arden Hills, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.