Individual provider Active NPI

Russell S Sudbury, MD

  • Family Medicine Physician
  • Rhinelander, WI
National Provider Identifier
1548215312
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29680 Issued in WI
Practice address
2251 N Shore Dr
Rhinelander, WI 54501-8360
Phone
(715) 361-4700
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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 29680 WI Primary

Addresses

Primary practice location

2251 N Shore Dr
Rhinelander, WI 54501-8360

Mailing address

2251 N Shore Dr
Rhinelander, WI 54501-8360
Phone (715) 361-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20090218000264 WI Practitioner - Family Practice 8123183563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2251 N Shore Dr
Suite 100
Rhinelander, WI 54501-6710
Phone (715) 361-2000

Hospital & facility affiliations

  • Aspirus Tomahawk Hospital Hospital, Tomahawk, WI, CCN 521313

Merit-based Incentive Payment System (MIPS)

Final score
87.84 of 100Reported as group
Quality
86.21
Promoting interoperability
100
Improvement activities
40
Cost
73.25

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Oct 16, 1994 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Oct 16, 1994 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

1020 Kabel Ave
Rhinelander, WI 54501
Phone (715) 361-2805

2251 N Shore Dr
Rhinelander, WI 54501
Phone (715) 361-2300

444 E Timber Dr
Rhinelander, WI 54501
Phone (715) 369-2300

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

Interoperability endpoints

  • Direct secure messaging: rsudbury169517@direct.aspirus.org

Organizations & group practices 2

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1548215312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 N SHORE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545018360",
            "telephone_number": "715-361-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 N SHORE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545018360",
            "telephone_number": "715-361-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDBURY",
        "first_name": "RUSSELL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "29680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rhinelander, WI

Sources for this page

Verify at the official NPI Registry.