Jeffrey Dane Russell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0005160 Issued in MD

Practice address

900 Caton Ave
Baltimore, MD 21229-5201

Phone

(410) 368-2000

NPI assigned

Sep 26, 2013

Last updated

Sep 26, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MD, DC, VA, MA4 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 4

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

64.75 of 100Reported as group

Quality

55.37

Improvement activities

40

Cost

47.65

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

70.94

Improvement activities

40

Cost

92.94

Merit-based Incentive Payment System (MIPS)

Final score

65.27 of 100Reported as group

Quality

45.09

Improvement activities

40

Cost

66.23

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffrey.russell.1@13869.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cep America LLC

  dba Vituity

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1821434002
  Medicare reassignment NPD
• True North Health Navigation LLC

  dba Dispatch Health

  • Emergency Medicine Physician
  • Denver, CO
  • NPI 1740622133

  DC, VA

  Medicare reassignment NPD
• Carelon Medical Partners, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1124443403

  DC, VA

  Medicare reassignment
• Dispatchhealth Massachusetts PC

  • Emergency Medicine Physician
  • Auburn, MA
  • NPI 1629555842
  Medicare reassignment
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Dispatchhealth NV Wagner PC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1023538790
  NPD (past)
• Excella Home Health Agency, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Ludlow, MA
  • NPI 1356642110
  NPD (past)
• True North Health Navigation LLC

  dba Dispatchhealth VA

  • Emergency Medicine Physician
  • Richmond, VA
  • NPI 1265950372
  NPD (past)

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1518394204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CATON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295201",
            "telephone_number": "410-368-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JEFFREY",
        "middle_name": "DANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-26",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernadette Russell, CPNP
• Brendan Russell, OTR/L
• Datavia Russell, LPN
• Donald Martin Russell, DDS ORTHODONTIST
• James W Russell, MD
• Jennifer K Russell, CCC-SLP
• Johnnetta Russell
• Julia Russell
• Kristine Russell, CRNP
• Lauren Russell

• Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.