Individual provider Active NPI

Brad C Russell, P.A.

  • Surgical Physician Assistant
  • Bel Air, MD
National Provider Identifier
1487696415
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C0003144 Issued in MD
Practice address
520 Upper Chesapeake Dr
Suite 306
Bel Air, MD 21014-4339
Phone
(410) 879-2006
Fax
(410) 879-0248
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X C0003144 MD Primary

Addresses

Primary practice location

520 Upper Chesapeake Dr
Suite 306
Bel Air, MD 21014-4339

Mailing address

520 Upper Chesapeake Dr
Suite 306
Bel Air, MD 21014-4339
Phone (410) 879-2006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070302000098 MD Practitioner - Physician Assistant 6406958800 Reassigns benefits to 2 organizations
I20230410001327 DE Practitioner - Physician Assistant 6406958800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular Surgery Associates LLCGroup PAC ID 3173500410, 13 clinicians

Practice addresses (Care Compare)

520 Upper Chesapeake Dr
Suite 306
Bel Air, MD 21014-4375
Phone (410) 879-2006

6569 N Charles St
Suite 701
Towson, MD 20204-6832
Phone (410) 825-4928

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.84 of 100Reported as group
Quality
73.85
Promoting interoperability
88
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0003144MDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Surgery Associates, L.L.C. CurrentSince Jun 9, 2014 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Dec 1, 2012 Accepting new patients
Midatlantic Cardiovascular Associates PA Past Accepting new patients
St. Joseph Physician Enterprise Past Accepting new patients

Locations

537 Stanton Christiana Rd
Ste 212
Newark, DE 19713
Phone (302) 633-9033

3435 Box Hill Corporate Center Dr
Ste H
Abingdon, MD 21009
Phone (410) 879-2006

2411 W Belvedere Ave
Ste 301
Baltimore, MD 21215
Phone (410) 601-0500

520 Upper Chesapeake Dr
Ste 306
Bel Air, MD 21014
Phone (410) 879-2006

111 W High St
Ste 303
Elkton, MD 21921
Phone (410) 392-2380

111 W High St
Ste 103
Elkton, MD 21921
Phone (410) 836-0131

3300 North Ridge Rd
Ste 100
Ellicott City, MD 21043
Phone (443) 819-3710

77 Thomas Johnson Dr
Ste E
Frederick, MD 21702
Phone (301) 695-8346

10 Crossroads Dr
Owings Mills, MD 21117
Phone (410) 469-4400

1838 Greene Tree Rd
Ste 430
Pikesville, MD 21208
Phone (410) 602-8637

6569 N Charles St
Ste 701
Towson, MD 21204
Phone (410) 825-4928

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

7505 Osler Dr
Ste 204
Towson, MD 21204
Phone (410) 427-5555

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: brussell135569@direct.umm.edu
  • Direct secure messaging: brad.russell.p1@direct.vsadocs.nextgenshare.com

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1487696415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR",
            "address_2": "SUITE 306",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144339",
            "telephone_number": "410-879-2006",
            "fax_number": "410-879-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR",
            "address_2": "SUITE 306",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144339",
            "telephone_number": "410-879-2006",
            "fax_number": "410-879-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BRAD",
        "middle_name": "C",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0003144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.