Kathleen Russell, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

OEG001346 Issued in PA

Practice address

295 Buck Rd
Suite 114
Holland, PA 18966-1733

Phone

(215) 953-1200

Fax

(215) 953-1201

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katie Russell Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Pennsylvania LLCGroup PAC ID 3971884883, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myeyedr Optometry of Pennsylvania, LLC

  • Optometrist
  • Carlisle, PA
  • NPI 1003264607
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Pennsylvania, LLC

  • Optometrist
  • Cranberry Township, PA
  • NPI 1093688491
  NPD
• Myeyedr Optometry of Pennsylvania, LLC

  • Optometrist
  • Southampton, PA
  • NPI 1447761200
  NPD

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1588683064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 BUCK RD",
            "address_2": "SUITE 114",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189661733",
            "telephone_number": "215-953-1200",
            "fax_number": "215-953-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 BUCK RD",
            "address_2": "SUITE 114",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189661733",
            "telephone_number": "215-953-1200",
            "fax_number": "215-953-1201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "482 2nd Street Pike",
            "address_purpose": "LOCATION",
            "city": "Southampton",
            "state": "PA",
            "postal_code": "189663803",
            "country_code": "US",
            "telephone_number": "215-355-7733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KATHLEEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "PA",
            "license": "OEG001346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "RUSSELL",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua Edward Roberts, D.C.
• Jennifer Rosenblum, BCBA
• Larry A. Roth, D.C.
• Leslie Sherman Rothberg, LCSW
• Mark D Rubin
• Staci H. Safady, AU.D.
• Maureen E. Sagot, PH.D.
• Anabelle Scalora, OTD, OTR/L
• Richard Robert Schermond, LCSW
• Amanda Schlupp, LCSW

• Corneal and Contact Management Optometrist in Holland, PA
• Providers in Holland, PA by specialty
• Corneal and Contact Management Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.