Individual provider Active NPI

Brandon Russell, D.O.

  • Emergency Medicine Physician
  • Huntington, IN
National Provider Identifier
1588603708
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34C.000055 Issued in OH
Practice address
2001 Stults Rd
Huntington, IN 46750-1291
Phone
(260) 482-4440
Fax
(260) 482-4442
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34C.000055 OH Primary
Emergency Medicine Physician 207P00000X 02003088-A IN

Addresses

Primary practice location

2001 Stults Rd
Huntington, IN 46750-1291

Mailing address

1791 Charlotte Landing Rd
Springport, MI 49284-9423
Phone (260) 665-2141

Other practice location 1

2121 Lake Ave
Fort Wayne, IN 46805-5100
Phone (260) 426-5431

Other identifiers 1

IdentifierTypeStateIssuer
200825030MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN, OH3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20040921001232 MI Practitioner - Emergency MedicinePractitioner - General Practice 6608844295 Reassigns benefits to 1 organization
I20060801000243 IN Practitioner - Emergency Medicine 6608844295 Reassigns benefits to 6 organizations
I20230110001383 OH Practitioner - Emergency Medicine 6608844295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Emergency Physicians PCGroup PAC ID 2769384213, 79 clinicians
Emergency Professionals of Indiana PCGroup PAC ID 4183604150, 118 clinicians

Practice addresses (Care Compare)

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 266-1000

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-2699

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
71.45
Promoting interoperability
100
Improvement activities
40
Cost
75.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02003088INMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Borgess Hospital CurrentSince May 3, 2014 Accepting new patients
Ascension Borgess Hospital Emergency Medicine CurrentSince May 3, 2014 Accepting new patients
Cameron Memorial Community Hospital, Inc CurrentSince Jul 27, 2020 Accepting new patients
Marion General Hospital CurrentSince Oct 21, 2024 Accepting new patients
Emergency Professionals of Indiana, P.C. Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
Concord Medical Group of Kentucky PLLC Emergency Medicine CurrentSince Sep 26, 2024 Accepting new patients
Marion General Hospital CurrentSince Oct 21, 2024 Accepting new patients
Cameron Memorial Community Hospital, Inc. CurrentSince Jul 27, 2020 Accepting new patients
Ascension Borgess Hospital Current Accepting new patients
Community Hospital of Lagrange County Inc Current Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine Past Accepting new patients
Indiana Emergency Professionals PC Emergency Medicine Past Accepting new patients

Locations

1381 N Wayne St
Angola, IN 46703
Phone (219) 481-4700

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

911 Marion Health Dr
Gas City, IN 46933
Phone (765) 660-7000

4781 Kaybee Dr
Gas City, IN 46933
Phone (765) 660-7840

207 N Townline Rd
Lagrange, IN 46761
Phone (260) 266-5300

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

330 N Wabash Ave
Ste G-20
Marion, IN 46952
Phone (765) 660-7600

1400 E 9th St
Rochester, IN 46975
Phone (574) 223-2020

411 W Tipton St
Seymour, IN 47274
Phone (317) 888-3505

2200 N Section St
Sullivan, IN 47882
Phone (812) 268-6292

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

701 S Health Parkway
Three Rivers, MI 49093
Phone (269) 273-9691

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 5

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1588603708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 CHARLOTTE LANDING RD",
            "city": "SPRINGPORT",
            "state": "MI",
            "postal_code": "492849423",
            "telephone_number": "260-665-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 STULTS RD",
            "city": "HUNTINGTON",
            "state": "IN",
            "postal_code": "467501291",
            "telephone_number": "260-482-4440",
            "fax_number": "260-482-4442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 Lake Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468055100",
            "country_code": "US",
            "telephone_number": "260-426-5431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BRANDON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34C.000055",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02003088-A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200825030",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, IN

Sources for this page

Verify at the official NPI Registry.