Russell Charles Maulitz, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD017259E Issued in PA

Practice address

210 S 25TH St Unit 606
Philadelphia, PA 19103-5876

Phone

(215) 805-6915

NPI assigned

Jun 15, 2006

Last updated

Jul 23, 2024By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Drexel University

  dba Drexel Psychology

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  Medicare reassignment NPD
• Drexel University

  dba Pennsylvania Ear Institute

  • Audiologist
  • Elkins Park, PA
  • NPI 1104822253
  NPD
• Drexel University

  dba Drexel Family Medicine

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1356458772
  NPD

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1396789194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S 25TH ST UNIT 606",
            "address_2": "SUITE 606",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191035876",
            "telephone_number": "215-805-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S 25TH ST UNIT 606",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191035876",
            "telephone_number": "215-805-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAULITZ",
        "first_name": "RUSSELL",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD017259E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000662893",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Theresa Mauch
• Shannon Maude, M.D.
• Jacob Andrew Mauersberg, MT-BC
• Jonathan Everett Mauger, M.S.
• Brittany Maulen
• Maureen P Kelly MD PC
• Alan H Maurer, MD
• Beth Maurer, CRNA
• Kristin Maurer, MS LPC
• Lydia Rose Maurer, MD

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.