Corey B Russell, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36002914 Issued in OH

Practice address

3055 W Sylvania Ave
Toledo, OH 43613-4135

Phone

(419) 473-0125

Fax

(419) 473-1230

NPI assigned

Apr 26, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brent L Rubin and Associates IncGroup PAC ID 8820092042, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: crussell100376@direct.bsmhealth.org

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.

• Brent L. Rubin & Associates Inc

  dba Foot & Ankle Physicians & Surgeons

  • Podiatrist
  • Toledo, OH
  • NPI 1922031400
  Medicare reassignment Care Compare group NPD
• Brent L. Rubin & Associates Inc

  • Podiatrist
  • Perrysburg, OH
  • NPI 1285289439
  NPD

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

• Mercy Health - St Vincent Medical Center LLC

  dba Mercy Health St Vincent Medical Center

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1467493551
  Care Compare affiliation

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1467418418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 W SYLVANIA AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436134135",
            "telephone_number": "419-473-0125",
            "fax_number": "419-473-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 W SYLVANIA AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436134135",
            "telephone_number": "419-473-0125",
            "fax_number": "419-473-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "COREY",
        "middle_name": "B",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2071109",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Joseph Rusk, MD
• De Ante Russ
• John Albert Russ III, MD
• Antuanette Russell
• Benjamin Russell
• Denise Russell
• Jamar Russell
• Jeff Russell
• Jewia D Russell, QMHS
• Jherica Russell

• Podiatrist in Toledo, OH
• Providers in Toledo, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.

Verify at the official NPI Registry.