Individual provider Active NPI

Joseph L. a. Russell, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • North Charleston, SC
National Provider Identifier
1578855433
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
51474 Issued in SC
Practice address
2850 Tricom St
North Charleston, SC 29406-9171
Phone
(843) 863-1188
Fax
(843) 863-8286
NPI assigned
May 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X Q6275 TX
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 51474 SC Primary

Addresses

Primary practice location

2850 Tricom St
North Charleston, SC 29406-9171

Mailing address

2850 Tricom St
North Charleston, SC 29406-9171
Phone (843) 863-1188

Other practice location 1

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171115002012 SC Practitioner - Otolaryngology 8628368438 Reassigns benefits to 2 organizations
I20171207003288 TX Practitioner - Otolaryngology 8628368438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of South Carolina School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians
Charleston Surgical Consultants LLCGroup PAC ID 4981106531, 5 clinicians

Practice addresses (Care Compare)

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-1166

2850 Tricom St
North Charleston, SC 29406-9192
Phone (843) 817-0488

900 Bowman Rd
Suite 201
Mount Pleasant, SC 29464-3221
Phone (843) 971-0139

Hospital & facility affiliations

  • Trident Medical Center Hospital, Charleston, SC, CCN 420079
  • JPS Health Network Hospital, Fort Worth, TX, CCN 450039

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51474SCMDOtolaryngology/Facial Plastic Surgery Physician
Q6275TXMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Surgical Consultants, LLC Otolaryngology/Facial Plastic Surgery CurrentSince Oct 1, 2025 Accepting new patients
National Allergy Asthma & Urticaria Centers of Charleston, PA CurrentSince Nov 1, 2017 Accepting new patients
National Allergy Asthma & Urticaria Centers of Charleston PA CurrentSince Nov 1, 2017 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Sep 2, 2025 Accepting new patients
National Allergy Asthma & Urticaria Centers of Charleston PA Past Accepting new patients
National Allergy Asthma & Urticaria Centers of Charleston PA Past Accepting new patients
Andrew Jacono MD PLLC Past Accepting new patients

Locations

730 Stony Landing Rd
Ste 200
Moncks Corner, SC 29461
Phone (843) 285-2500

900 Bowman Rd
Ste 201
Mt Pleasant, SC 29464
Phone (843) 797-8162

7555 Northside Dr
North Charleston, SC 29420
Phone (843) 797-8162

2850 Tricom St
North Charleston, SC 29406
Phone (843) 817-0488

9165 University Blvd
North Charleston, SC 29406
Phone (843) 797-8162

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450

Organizations & group practices 7

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 2

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": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1578855433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-863-1188",
            "fax_number": "843-863-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-863-1188",
            "fax_number": "843-863-8286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "817-702-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JOSEPH",
        "middle_name": "L. A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-11",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "TX",
            "license": "Q6275",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "SC",
            "license": "51474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.