Individual provider Active NPI

Robert Isaac Oleen Russell, MD

  • Emergency Medicine Physician
  • Arlington, VA
National Provider Identifier
1376003616
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101274334 Issued in VA
Practice address
1701 N George Mason Dr
Arlington, VA 22205-3610
Phone
(240) 686-2300
Fax
(240) 686-2330
NPI assigned
Mar 22, 2019
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X D94009 MD
Emergency Medicine Physician 207P00000X 0101274334 VA Primary

Addresses

Primary practice location

1701 N George Mason Dr
Arlington, VA 22205-3610

Mailing address

PO Box 800699
Charlottesville, VA 22908-0816
Phone (434) 924-8485

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 924-8485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20220715000017 DC Practitioner - Emergency Medicine 5890022354 Reassigns benefits to 1 organization
I20220719003440 VA Practitioner - Emergency Medicine 5890022354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D94009MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Jul 1, 2022 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jul 1, 2022 Accepting new patients
Arnot Medical Services PLLC Emergency Medicine Past Accepting new patients

Locations

12420 Milestone Center Dr
Ste 200
Germantown, MD 20876
Phone (336) 509-7515

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1376003616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800699",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-8485",
            "fax_number": "434-982-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N GEORGE MASON DR",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053610",
            "telephone_number": "240-686-2300",
            "fax_number": "240-686-2330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-8485",
            "fax_number": "434-982-4118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ROBERT",
        "middle_name": "ISAAC OLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D94009",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101274334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.