Deidre Russell, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

48632 Issued in AZ

Practice address

21300 N John Wayne Pkwy Ste 121
Maricopa, AZ 85139-8978

Phone

(480) 821-3600

Fax

(480) 857-2667

NPI assigned

Aug 16, 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 AZ

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

Specialty

Obstetrics/Gynecology

Education

University of Texas Southwestern Medical School at Dallas, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Momdoc LLCGroup PAC ID 3375534282, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Momdoc, LLC

  • Obstetrics & Gynecology Physician
  • Chandler, AZ
  • NPI 1184780355
  Medicare reassignment Care Compare group
• Deidre J. Russell, M.D.,LLC

  • Specialist
  • Selma, AL
  • NPI 1003863846
  NPD (past) Authorized official
• Healthy Pregnancy Perinatology, LLC

  • Maternal & Fetal Medicine Physician
  • Gilbert, AZ
  • NPI 1467725812
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1467565341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6730",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466730",
            "telephone_number": "480-821-3600",
            "fax_number": "480-857-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 N JOHN WAYNE PKWY STE 121",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851398978",
            "telephone_number": "480-821-3600",
            "fax_number": "480-857-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DEIDRE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "48632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "906341",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Rosenstock, CERTIFIED DOULA
• Melissa Ann Ross, FNP-C
• Robin K Rowray, RN
• Courtney Christine Ruby, MSN, APRN, FNP-BC
• Martha Ruiz
• Sananga Care Homes LLC
• Elisa Sanchez
• Kay Sanford
• Arielle Sanger, FNP
• Santa Cruz Elementary School

• Obstetrics & Gynecology Physician in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Obstetrics & Gynecology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.
• 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.