Active NPI
Raymond S Russell, M.D.
- Urology Physician
- Miamisburg, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 35073039
- Practice address
- 4000 Miamisburg Centerville Rd
Suite 405
Miamisburg, OH 45342-7615 - Phone
- (937) 560-2011
- Fax
- (937) 560-2012
- NPI assigned
- May 26, 2006
- Last updated
- Nov 24, 2020
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 35073039 | OH | Primary |
Addresses
Primary practice location
4000 Miamisburg Centerville Rd
Suite 405
Miamisburg, OH 45342-7615
Mailing address
4000 Miamisburg Centerville Rd Ste 207
Miamisburg, OH 45342-3674
Phone (937) 560-2011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2169380 | Medicaid | OH |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rrussell189306@direct.ketteringhealth.org | ||
| FHIR URL | https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4000 Miamisburg Centerville Rd
Suite 450
Miamisburg, OH 45342-3908
Phone (937) 560-2011
4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309
4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751
Hospital & facility affiliations
- Kettering Health Miamisburg
- Kettering Health Dayton
- Kettering Health Main Campus
- Soin Medical Center
- Kettering Health Troy
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.8 of 100
- Quality
- 73.21
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.12
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.34 of 100
- Quality
- 63.67
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.14
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35073039 | OH | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metro Golden Medical, LLC | Current | Accepting new patients | |
| Reid Physician Associates, Inc | Current | Accepting new patients | |
| Kettering Independent Medical Group Inc | Current | Accepting new patients | |
| Reid Physician Associates, Inc. | Current | Accepting new patients | |
| Lincoln Park Surgery Center | Past | Accepting new patients |
Locations
1050 Reid Pkwy
Ste 325
Richmond, IN 47374
Phone (765) 935-8905
1100 Reid Pkwy
Richmond, IN 47374
Phone (765) 983-3000
425 W Grand Ave
Ste 1006
Dayton, OH 45405
Phone (937) 226-7871
3533 Southern Blvd
Ste 5200
Kettering, OH 45429
Phone (937) 395-8002
4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910
4000 Miamisburg Centerville Rd
Ste 405
Miamisburg, OH 45342
Phone (937) 439-3600
4000 Miamisburg Centerville Rd
Ste 435
Miamisburg, OH 45342
Phone (937) 384-4511
1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306
4000 Miamisburg Centerville Rd
Ste 207
Miamisburg, OH 45342
Phone (937) 560-2011
4000 Miamisburg Centerville Rd
Ste 450
Miamisburg, OH 45342
Phone (937) 439-3600
Interoperability endpoints
- rrussell484095@reidhealth.direct-ci.com
Organizations & group practices 5
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.
-
- Orthopaedic Surgery Physician
- Miamisburg, OH
- NPI 1629387865
-
dba Reid Health Physician Associates
- Internal Medicine Physician
- Richmond, IN
- NPI 1265689111
-
dba Reid Health X-Ray Winchester
- Radiology Clinic/Center
- Winchester, IN
- NPI 1417653221
-
- Radiology Clinic/Center
- Kettering, OH
- NPI 1912989526
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Soin Medical Center
- General Acute Care Hospital
- Beavercreek, OH
- NPI 1760764849
-
dba Kettering Health Dayton
- General Acute Care Hospital
- Dayton, OH
- NPI 1053339507
-
dba Kettering Health Troy
- General Acute Care Hospital
- Troy, OH
- NPI 1023587045
-
dba Kettering Health Main Campus
- General Acute Care Hospital
- Kettering, OH
- NPI 1043233984
-
dba Kettering Health Miamisburg
- General Acute Care Hospital
- Miamisburg, OH
- NPI 1316966518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606176000000",
"number": "1447206933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 MIAMISBURG CENTERVILLE RD STE 207",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453423674",
"telephone_number": "937-560-2011",
"fax_number": "937-560-2012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 MIAMISBURG CENTERVILLE RD",
"address_2": "SUITE 405",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453427615",
"telephone_number": "937-560-2011",
"fax_number": "937-560-2012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "RAYMOND",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2020-11-24",
"certification_date": "2020-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "OH",
"license": "35073039",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2169380",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rrussell189306@direct.ketteringhealth.org",
"affiliation": "N",
"address_1": "4000 Miamisburg Centerville Rd",
"address_2": "Suite 405",
"city": "Miamisburg",
"state": "OH",
"country_code": "US",
"postal_code": "453427615",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "4000 Miamisburg Centerville Rd",
"address_2": "Suite 405",
"city": "Miamisburg",
"state": "OH",
"country_code": "US",
"postal_code": "453427615",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Miamisburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.