Individual provider Active NPI

Andrew David Russell, DPT

  • Physical Therapist
  • Lancaster, PA
National Provider Identifier
1659695807
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT020451 Issued in PA
Practice address
2481 Lincoln Hwy E
Suite 4
Lancaster, PA 17602-1482
Phone
(717) 925-2100
Fax
(717) 390-1953
NPI assigned
Mar 17, 2010
Last updated
Jul 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT020451 PA Primary

Addresses

Primary practice location

2481 Lincoln Hwy E
Suite 4
Lancaster, PA 17602-1482

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120404000195 PA Practitioner - Physical Therapist in Private Practice 7113187824 Reassigns benefits to 1 organization
I20210423000109 DE Practitioner - Physical Therapist in Private Practice 7113187824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

100 Valley Ctr Rd
Wilmington, DE 19808-2950
Phone (302) 994-1200

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT020451PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Mar 18, 2013 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Mar 18, 2013 Accepting new patients

Locations

2032 New Castle Ave
New Castle, DE 19720
Phone (302) 654-1700

2600 Glasgow Ave
Ste 105
Newark, DE 19702
Phone (302) 836-8287

100 Valley Center Rd
Wilmington, DE 19808
Phone (302) 229-1986

213 Greenhill Ave
Ste C
Wilmington, DE 19805
Phone (302) 658-7800

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

82 Pennsylvania Ave
Avondale, PA 19311
Phone (610) 268-5333

2481 Lincoln Hwy E
Ste 4
Lancaster, PA 17602
Phone (717) 925-2100

9475 Roosevelt Blvd
Philadelphia, PA 19114
Phone (215) 464-6200

118 Townsedge Dr
Quarryville, PA 17566
Phone (717) 806-5126

105 Vineyard Way
Ste 100
West Grove, PA 19390
Phone (610) 869-5792

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1659695807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2481 LINCOLN HWY E",
            "address_2": "SUITE 4",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176021482",
            "telephone_number": "717-925-2100",
            "fax_number": "717-390-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-17",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT020451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.