NPIMap

Individual provider Active NPI

Marie Ann Russell, MD.

  • Internal Medicine Physician
  • San Marcos, CA
National Provider Identifier
1609947449
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
28355 Issued in AZ
Practice address
150 Valpreda Rd
San Marcos, CA 92069-2973
Phone
(760) 736-8689
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28355 AZ Primary

Addresses

Primary practice location

150 Valpreda Rd
San Marcos, CA 92069-2973

Mailing address

PO Box 31001-0698
Pasadena, CA 91110-0698
Phone (602) 263-1511

Other identifiers 2

IdentifierTypeStateIssuer
634685MedicaidAZ
AZ0713260OtherAZBCBSAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100322000599 TX Practitioner - Internal Medicine 2466587068 Reassigns benefits to 1 organization
I20230628001586 CA Practitioner - Internal Medicine 2466587068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North County Health Project IncGroup PAC ID 2769390939, 56 clinicians

Practice addresses (Care Compare)

150 Valpreda Rd
San Marcos, CA 92069-2973
Phone (619) 736-6700

1595 Grand Ave
San Marcos, CA 92078-2450
Phone (760) 736-6767

220 Rotanzi St
Ramona, CA 92065-2583
Phone (760) 789-1223

295 S Rancho Santa Fe Rd
San Marcos, CA 92078-2301
Phone (760) 736-6767

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28355AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North County Health Project Inc CurrentSince Mar 14, 2023 Accepting new patients
North County Health Project Inc CurrentSince Mar 14, 2023 Accepting new patients
North County Health Project Inc Current Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Aug 6, 2001 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Aug 6, 2001 Accepting new patients

Locations

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

150 Valpreda Rd
San Marcos, CA 92069
Phone (619) 736-6700

1595 Grand Ave
Ste 100
San Marcos, CA 92078
Phone (760) 444-0523

Ownership & related parties

All facility ownership & control disclosures 15

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
TruecareSan Marcos, CA, CCN 551923 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareOceanside, CA, CCN 551935 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareOceanside, CA, CCN 551932 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareEncinitas, CA, CCN 551937 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareRamona, CA, CCN 551931 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareCarlsbad, CA, CCN 551933 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareOceanside, CA, CCN 551006 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecarePerris, CA, CCN 751912 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareSan Marcos, CA, CCN A01111 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareOceanside, CA, CCN A01110 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareSan Marcos, CA, CCN 051961 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareOceanside, CA, CCN A01859 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareOceanside, CA, CCN A01870 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareSan Marcos, CA, CCN A01951 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020
TruecareOceanside, CA, CCN A11010 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 4, 2020
May 4, 2020

Owned or controlled facilities with NPI records 15

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 15

Organizations & group practices 5

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1609947449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-0698",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100698",
            "telephone_number": "602-263-1511",
            "fax_number": "602-263-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 VALPREDA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692973",
            "telephone_number": "760-736-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MARIE",
        "middle_name": "ANN",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "28355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "634685",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAZ",
            "identifier": "AZ0713260",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.