Active NPI
Russell Herbert Pacquette, MD
- Internal Medicine Physician
- Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- U7131
- Practice address
- 11251 Fondren Rd
Houston, TX 77096-5507 - Phone
- (281) 707-7362
- NPI assigned
- Sep 22, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 79222 | GA | |
| Internal Medicine Physician | 207R00000X | U7131 | TX | Primary |
Addresses
Primary practice location
11251 Fondren Rd
Houston, TX 77096-5507
Mailing address
836 E. 65TH Street
Suite 20
Savannah, GA 31405
Phone (912) 819-7878
Other practice location 1
527 Eisenhower Drive
Savannah, GA 31406-1612
Phone (912) 819-9100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4301104108 | Other | MI | STATE LICENSE |
| 003208359A | Medicaid | GA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11251 Fondren Rd
Houston, TX 77096-5507
Phone (281) 707-7362
3500 Little York Rd
A 5
Houston, TX 77093-3658
Phone (281) 707-7358
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79222 | GA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SJC Medical Group Inc | Internal Medicine | Current | Accepting new patients |
| Oak Street Health of Texas, PLLC | Internal Medicine | Current | Accepting new patients |
| St. Joseph'S Cardiology Group, LLC | Past | Accepting new patients | |
| Candler ENT Practice, LLC | Past | Accepting new patients |
Locations
527 Eisenhower Dr
Savannah, GA 31406
Phone (912) 443-4200
11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452
602 E 72nd St
Savannah, GA 31405
Phone (912) 819-7800
2360 Gus Thomasson Rd
Dallas, TX 75228
Phone (314) 301-7071
4115 E Lancaster Ave
Fort Worth, TX 76103
Phone (817) 796-7370
3500 Little York Rd
#A5
Houston, TX 77093
Phone (281) 707-7358
11251 Fondren Rd
Houston, TX 77096
Phone (281) 707-7362
2115 S Broadway Ave
Tyler, TX 75701
Phone (903) 907-7002
Interoperability endpoints
- rpacquette6816@mymichiganhealth.midirect.net
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 and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Fort Worth, TX
- NPI 1497387419
Internal Medicine
-
- Otolaryngology Physician
- Savannah, GA
- NPI 1477969749
-
- Interventional Cardiology Physician
- Savannah, GA
- NPI 1619216058
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Houston, TX
- NPI 1730132234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715731200000",
"number": "1447568597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "836 E. 65TH STREET",
"address_2": "SUITE 20",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "31405",
"telephone_number": "912-819-7878",
"fax_number": "912-819-3555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11251 FONDREN RD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770965507",
"telephone_number": "281-707-7362"
}
],
"practiceLocations": [
{
"address_1": "527 Eisenhower Drive",
"address_purpose": "LOCATION",
"city": "Savannah",
"state": "GA",
"postal_code": "314061612",
"country_code": "US",
"telephone_number": "912-819-9100",
"fax_number": "912-819-9101",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PACQUETTE",
"first_name": "RUSSELL",
"middle_name": "HERBERT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-22",
"last_updated": "2024-05-15",
"certification_date": "2024-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "79222",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "U7131",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "4301104108",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003208359A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.
- 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.