Individual provider Active NPI

Russell Robert Janson, M.D.

  • Obstetrics & Gynecology Physician
  • Lemoyne, PA
National Provider Identifier
1669452694
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD028002E Issued in PA
Practice address
1 Lemoyne SQ
Suite 201
Lemoyne, PA 17043-1230
Phone
(717) 737-4511
Fax
(717) 909-6659
NPI assigned
Jan 17, 2006
Last updated
Aug 13, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD028002E PA Primary

Addresses

Primary practice location

1 Lemoyne SQ
Suite 201
Lemoyne, PA 17043-1230

Mailing address

1 Lemoyne SQ
Suite 201
Lemoyne, PA 17043-1230
Phone (717) 737-4511

Other identifiers 4

IdentifierTypeStateIssuer
32805OtherPAAETNA HMO PROVIDER NUMBER
50026628OtherPACAPITAL BLUE CROSS
57617OtherPAHIGHMARK BLUE SHIELD
4531553OtherPAAETNA PPO PROVIDER NUMBER

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050531000755 PA Practitioner - Obstetrics/Gynecology 5496741563 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Oct 9, 2010 Accepting new patients
Pinnacle Health Medical Services CurrentSince Oct 9, 2010 Accepting new patients
Pinnacle Health Medical Services Obstetrics & Gynecology Current Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

2645 N 3rd St
Harrisburg, PA 17110
Phone (717) 782-4650

Organizations & group practices 4

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1669452694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LEMOYNE SQ",
            "address_2": "SUITE 201",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431230",
            "telephone_number": "717-737-4511",
            "fax_number": "717-909-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LEMOYNE SQ",
            "address_2": "SUITE 201",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431230",
            "telephone_number": "717-737-4511",
            "fax_number": "717-909-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSON",
        "first_name": "RUSSELL",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD028002E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO PROVIDER NUMBER",
            "identifier": "32805",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50026628",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "57617",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO PROVIDER NUMBER",
            "identifier": "4531553",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemoyne, PA

Sources for this page

Verify at the official NPI Registry.