Karren Russo, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

L12631R Issued in LA

Practice address

2495 Shreveport Hwy
Pineville, LA 71360-4044

Phone

(318) 473-0010

NPI assigned

Mar 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

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

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 and National Provider Directory roles.

• Christus Health Central Louisiana

  • Internal Medicine Physician
  • Alexandria, LA
  • NPI 1497895130
  Medicare reassignment NPD
• Alexandria Eye and Laser Center, LLC

  • Ophthalmology Physician
  • Alexandria, LA
  • NPI 1538120985
  Medicare reassignment
• Christus Health Central Louisiana

  • General Acute Care Hospital
  • Alexandria, LA
  • NPI 1639160799
  NPD
• Welch Eye Center

  • Ophthalmology Physician
  • Alexandria, LA
  • NPI 1215978309
  NPD (past)

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1467413815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604044",
            "telephone_number": "318-473-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604044",
            "telephone_number": "318-473-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "KARREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "L12631R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1541362",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "P00178010",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Marie Roton, NP-C
• Gretchen Lynne Roy, LCSW
• Reuben Sanford Roy Jr., M.D.
• Gary Jay Rubenstein, D.C.
• Baylee Russell
• Ryland Dental Association
• Cote L Ryland, D.D.S
• Hillee Salley
• Ja'Nae Sanders, PHARMD
• Kelley M Sandoval, RAC

• Ophthalmology Physician in Pineville, LA
• Providers in Pineville, LA by specialty
• Ophthalmology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.