Individual provider Active NPI

Ian Russinoff, MD

  • Emergency Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1477548295
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME 91596 Issued in FL
Practice address
1411 N Flagler Dr Ste 6200
West Palm Beach, FL 33401-3416
Phone
(561) 820-8580
Fax
(561) 820-8581
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME 91596 FL Primary

Addresses

Primary practice location

1411 N Flagler Dr Ste 6200
West Palm Beach, FL 33401-3416

Mailing address

10260 S Barnsley Dr
Parkland, FL 33076-4460
Phone (917) 692-4892

Other identifiers 2

IdentifierTypeStateIssuer
271745000MedicaidFL
01571OtherFLMEDICARE CORE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20050902000012 FL Practitioner - Internal MedicinePractitioner - Emergency Medicine 1850323569 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
State University of New York Downstate Medical Center, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1411 N Flagler Dr
Suite 4000
West Palm Beach, FL 33401-3411
Phone (561) 820-8580

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, West Palm Beach, FL, CCN 107714
  • Good Samaritan Medical Center Hospital, West Palm Beach, FL, CCN 100287
  • Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 91596FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriela Goldstein MD PA CurrentSince Feb 12, 2023 Accepting new patients
Russinoff Concierge PA CurrentSince Oct 30, 2024 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Phoenix Emergency Medicine of Broward LLC Emergency Medicine CurrentSince Jul 1, 2005 Accepting new patients

Locations

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

1411 N Flagler Dr
Ste 4000
West Palm Beach, FL 33401
Phone (561) 832-6113

1411 N Flagler Dr
Ste 6200
West Palm Beach, FL 33401
Phone (561) 659-1238

Interoperability endpoints

  • Direct secure messaging: ian.russinoff.1@28599.direct.athenahealth.com
  • Direct secure messaging: irussinoff467440@direct.ccf.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1477548295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10260 S BARNSLEY DR",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330764460",
            "telephone_number": "917-692-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR STE 6200",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013416",
            "telephone_number": "561-820-8580",
            "fax_number": "561-820-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSINOFF",
        "first_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME 91596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271745000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CORE",
            "identifier": "01571",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.