NPIMap

Individual provider Active NPI

Russell Mascarenhas, M.D.

  • Family Medicine Physician
  • Refugio, TX
National Provider Identifier
1497863906
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K0920 Issued in TX
Practice address
107 1/2 Swift St
Refugio, TX 78377-2425
Phone
(361) 526-5328
Fax
(361) 526-5670
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K0920 TX Primary

Addresses

Primary practice location

107 1/2 Swift St
Refugio, TX 78377-2425

Mailing address

107 1/2 Swift St
Refugio, TX 78377-2425
Phone (361) 526-5328

Other identifiers 2

IdentifierTypeStateIssuer
121272202MedicaidTX
K0920OtherTXSTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110221000102 TX Practitioner - Internal MedicinePractitioner - Family Practice 8123209434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Refugio County Memorial Hospital DistrictGroup PAC ID 1153216783, 11 clinicians

Practice addresses (Care Compare)

107 Swift St
Refugio, TX 78377-2425
Phone 3615262321138

Hospital & facility affiliations

  • Siloe Home Health & Infusion, LLC Home health agency, Rockport, TX, CCN 679686
  • Excel Complete Home Healthcare Inc Home health agency, Victoria, TX, CCN 677920
  • Hospice of South Texas Inc Hospice, Victoria, TX, CCN 451525
  • Refugio County Memorial Hospital Hospital, Refugio, TX, CCN 451317
  • Citizens Medical Center Hospital, Victoria, TX, CCN 450023
  • De Tar Hospital Navarro Hospital, Victoria, TX, CCN 450147
  • Mission Ridge Rehab & Nursing Center Nursing home, Refugio, TX, CCN 676491
  • La Bahia Nursing & Rehabilitation Nursing home, Goliad, TX, CCN 675372
  • Refugio County Memorial Hospital Nursing home, CCN 45Z317

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K0920TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Refugio County Memorial Hospital District Current Accepting new patients
Goliad I Enterprises, L.L.C. Past Accepting new patients
Refugio II Enterprises, L.L.C. Past Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

107 Swift St
Refugio, TX 78377
Phone (361) 526-2321

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 9

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1497863906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 1/2 SWIFT ST",
            "city": "REFUGIO",
            "state": "TX",
            "postal_code": "783772425",
            "telephone_number": "361-526-5328",
            "fax_number": "361-526-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 1/2 SWIFT ST",
            "city": "REFUGIO",
            "state": "TX",
            "postal_code": "783772425",
            "telephone_number": "361-526-5328",
            "fax_number": "361-526-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCARENHAS",
        "first_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K0920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121272202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "K0920",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Refugio, TX

Sources for this page

Verify at the official NPI Registry.