Individual provider Active NPI

Russell Todd Topham, MD

  • Internal Medicine Physician
  • Tyler, TX
National Provider Identifier
1437138005
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K3498 Issued in TX
Practice address
3309 University Blvd
Tyler, TX 75701
Phone
(903) 565-0303
Fax
(903) 565-5446
NPI assigned
Jan 12, 2006
Last updated
Aug 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K3498 TX Primary

Addresses

Primary practice location

3309 University Blvd
Tyler, TX 75701

Mailing address

3309 University Blvd
Tyler, TX 75701
Phone (903) 565-0303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20040624000032 TX Practitioner - Internal Medicine 7719962554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magnolia Internal Medicine Associates PAGroup PAC ID 3971567124, 2 clinicians

Practice addresses (Care Compare)

3309 University Blvd
Tyler, TX 75701-6602
Phone (903) 565-0303

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
28.92 of 100Reported as individual
Quality
25
Improvement activities
0
Cost
63.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions14
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K3498TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Internal Medicine Associates PA Internal Medicine CurrentSince Aug 26, 2004 Accepting new patients

Locations

3309 University Blvd
Tyler, TX 75701
Phone (903) 360-7781

Organizations & group practices 1

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1437138005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 UNIVERSITY BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-565-0303",
            "fax_number": "903-565-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 UNIVERSITY BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-565-0303",
            "fax_number": "903-565-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOPHAM",
        "first_name": "RUSSELL",
        "middle_name": "TODD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K3498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.