Jeremy Lawrence Russell, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

332993 Issued in LA

Practice address

15790 Paul Vega MD Dr
Hammond, LA 70403-1436

Phone

(985) 345-2700

Fax

(985) 230-6653

NPI assigned

Jun 8, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Louisiana State University School of Medicine in New Orleans, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Oaks Medical Center LLCGroup PAC ID 2466629522, 317 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Oaks Medical Center Hospital, Hammond, LA, CCN 190015

Merit-based Incentive Payment System (MIPS)

Final score

86.91 of 100Reported as group

Quality

78.17

Promoting interoperability

100

Improvement activities

40

Cost

67.71

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• North Oaks Medical Center, LLC

  dba Hospital Based Physicians - Radiologists

  • Diagnostic Radiology Physician
  • Hammond, LA
  • NPI 1164785648
  Medicare reassignment Care Compare group
• North Oaks Medical Center, LLC

  dba North Oaks Med Ctr Professional Billing

  • General Acute Care Hospital
  • Hammond, LA
  • NPI 1972630705
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Oaks Medical Center, LLC

  • Rural Acute Care Hospital
  • Hammond, LA
  • NPI 1144227539
  Care Compare affiliation

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1639808306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1389",
            "city": "ALBANY",
            "state": "LA",
            "postal_code": "707111389",
            "telephone_number": "985-320-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15790 PAUL VEGA MD DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031436",
            "telephone_number": "985-345-2700",
            "fax_number": "985-230-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JEREMY",
        "middle_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "1196694",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "LA",
            "license": "332993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1639808306",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arielle Ruffin
• Kylie R Ruiz
• Vincent Joseph Rusciano, RPH
• April Rushing, M. ED., CCC-SLP
• James Thaddeus Russell, PH.D.
• Wanda L Russell
• Miranda Brown Rutland, NP
• Amy Elizabeth Ryan, FNP
• S. Joel Tewis, DDS, a Professional Dental Corporation (Affordable Dentures & Implants - Hammond)
• S. Tahseen Rab MD Apllc

• Surgical Physician Assistant in Hammond, LA
• Providers in Hammond, LA by specialty
• Surgical Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.