Individual provider Active NPI

Russell John Luke Maxwell, MD

  • Radiation Oncology Physician
  • Philadelphia, PA
National Provider Identifier
1649661190
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD480422 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4238
Phone
(215) 662-2428
Fax
(215) 349-5923
NPI assigned
Feb 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 25MA12059700 NJ
Radiation Oncology Physician 2085R0001X MD480422 PA Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4238

Mailing address

3400 Civic Center Blvd.
Pcam-2 West
Philadelphia, PA 19104
Phone (215) 662-2428

Other practice location 1

1865 Route 70 East
Ste 220
Cherry Hill, NJ 08003-2013
Phone (919) 395-7075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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
I20231114000418 PA Practitioner - Radiation OncologyPractitioner - Diagnostic Radiology 3476900481 Reassigns benefits to 1 organization
I20240925001271 NJ Practitioner - Radiation Oncology 3476900481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Johns Hopkins University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD480422PAMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Jul 13, 2024 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group Radiation Oncology CurrentSince Oct 9, 2023 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Radiation Oncology Current Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Jul 13, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 9, 2023 Accepting new patients
Univ of Penn Radiation Oncology Radiation Oncology Past Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

1865 Route 70 E
Ste 220
Cherry Hill, NJ 08003
Phone (856) 429-0505

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

1001 Chesterbrook Blvd
Berwyn, PA 19312
Phone (610) 576-7500

599 W State St
Ste 103
Doylestown, PA 18901
Phone (267) 880-2710

3400 Convention Ave
Philadelphia, PA 19104
Phone (215) 662-2300

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Civic Center Blvd
#2W
Philadelphia, PA 19104
Phone (215) 614-1618

145 King of Prussia Rd
#G101
Wayne, PA 19087

701 E Marshall St
West Chester, PA 19380
Phone (610) 431-5000

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 8

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 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": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1649661190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD.",
            "address_2": "PCAM-2 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-2428",
            "fax_number": "215-615-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2428",
            "fax_number": "215-349-5923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1865 Route 70 East",
            "address_2": "STE 220",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080032013",
            "country_code": "US",
            "telephone_number": "919-395-7075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "RUSSELL",
        "middle_name": "JOHN LUKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-05",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NJ",
            "license": "25MA12059700",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "PA",
            "license": "MD480422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.