Individual provider Active NPI

Barbara Kathryn Russell, D.O.

  • Neonatal-Perinatal Medicine Physician
  • Bronx, NY
National Provider Identifier
1538246608
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
185869 Issued in NY
Practice address
1650 Selwyn Ave
Suite 8B
Bronx, NY 10457-7626
Phone
(718) 579-2650
Fax
(718) 579-2659
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 185869 NY Primary

Addresses

Primary practice location

1650 Selwyn Ave
Suite 8B
Bronx, NY 10457-7626

Mailing address

70 E 96TH St
Apartment 13a
New York, NY 10128-0745
Phone (212) 288-9095

Other identifiers 1

IdentifierTypeStateIssuer
01452491MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20091123000505 NY Practitioner - Pediatric Medicine 5991844433 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Current Accepting new patients
Bronxcare Health System CurrentSince Oct 1, 2009 Accepting new patients
Bronxcare Health System CurrentSince Oct 1, 2009 Accepting new patients
Bronxcare Health System Past Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1650 Selwyn Ave
Apt 8B
Bronx, NY 10457
Phone (718) 579-2650

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538246608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 E 96TH ST",
            "address_2": "APARTMENT 13A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101280745",
            "telephone_number": "212-288-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 SELWYN AVE",
            "address_2": "SUITE 8B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577626",
            "telephone_number": "718-579-2650",
            "fax_number": "718-579-2659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BARBARA",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "185869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01452491",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.