Individual provider Active NPI

Laura Teresa Russo Herrera, MD

  • Internal Medicine Physician
  • Visalia, CA
National Provider Identifier
1487838660
Registry record updated Feb 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C56138 Issued in CA
Practice address
107 N Hall St
Suite E
Visalia, CA 93291-5850
Phone
(559) 734-6701
Fax
(559) 734-6701
NPI assigned
Dec 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C56138 CA Primary

Addresses

Primary practice location

107 N Hall St
Suite E
Visalia, CA 93291-5850

Mailing address

107 N Hall St
Suite E
Visalia, CA 93291-5850
Phone (559) 734-6701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140707001159 CA Practitioner - Internal Medicine 0648330282 Practice locations: Visalia, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3632 W Packwood Ave
Visalia, CA 93277-5033
Phone (559) 734-6701

Hospital & facility affiliations

  • Compassionate Care Home Health Agency, LLC Home health agency, Fresno, CA, CCN 058233
  • Kaweah Health Home Health Home health agency, Visalia, CA, CCN 057255
  • Kaweah Health Medical Center Hospital, Visalia, CA, CCN 050057
  • Adventist Health Tulare Hospital, Tulare, CA, CCN 050784

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C56138CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaweah Delta Health Care District Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AEIICD/Endpoint/AEIICD

Organizations & group practices 1

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 4

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": "1198368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391212800000",
    "number": "1487838660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N HALL ST",
            "address_2": "SUITE E",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915850",
            "telephone_number": "559-734-6701",
            "fax_number": "559-734-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N HALL ST",
            "address_2": "SUITE E",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915850",
            "telephone_number": "559-734-6701",
            "fax_number": "559-734-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO HERRERA",
        "first_name": "LAURA",
        "middle_name": "TERESA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-23",
        "last_updated": "2014-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C56138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.