Russell Paul Nycum, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP025550 Issued in PA

Practice address

620 Howard Ave
Altoona, PA 16601-4804

Phone

(814) 889-4189

NPI assigned

Apr 29, 2022

Last updated

Apr 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Adara Healthcare Staffing

  dba ADARA Psychiatric Mental Health Services

  • Adult Health Nurse Practitioner
  • Duncansville, PA
  • NPI 1215285515
  NPD
• Upmc Altoona

  • Ambulatory Surgical Clinic/Center
  • Altoona, PA
  • NPI 1114926953
  NPD
• Upmc Altoona

  dba Altoona Mental Health

  • Psychiatric Hospital
  • Altoona, PA
  • NPI 1760567283
  NPD

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1427793975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 PARK HEIGHTS RD",
            "city": "BEDFORD",
            "state": "PA",
            "postal_code": "155223875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 HOWARD AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166014804",
            "telephone_number": "814-889-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYCUM",
        "first_name": "RUSSELL",
        "middle_name": "PAUL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP025550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "russell.p.nycum@upmcdirect.com",
            "affiliation": "N",
            "address_1": "620 Howard Ave",
            "city": "Altoona",
            "state": "PA",
            "country_code": "US",
            "postal_code": "166014804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• North Star Services, Inc.
• Daniel T Novak Jr., DMD
• Tierra Lynn Novak
• Novum Laboratory, LLC
• Nutronics TM, Inc.
• Jennifer O
• Stacey O'Connor
• Peter Joseph O'Donnell, PSYCHOLOGIST
• Sarah Nicole O'Farrell, PA-C
• Nicole Marie O'Neill, PT, DPT

• Psychiatric/Mental Health Nurse Practitioner in Altoona, PA
• Providers in Altoona, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.