Russell Jayne MD LTD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

9106 Issued in NV

Legal business name

RUSSELL JAYNE MD LTD

Practice address

6839 W Charleston Blvd
Las Vegas, NV 89117-1635

Phone

(702) 737-7258

Fax

(702) 454-7258

NPI assigned

Jul 5, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Russell Patrick Jayne, MDNPI 1689671687

Title

President

Phone

(702) 737-7258

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Retina Center at Las Vegas Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell P Jayne, MD

  • Retina Specialist (Ophthalmology) Physician
  • Las Vegas, NV
  • NPI 1689671687
  Medicare reassignment NPD Authorized official
• Claudia M Krispel, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Henderson, NV
  • NPI 1922275791
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1669479663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50708",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890160708",
            "telephone_number": "702-737-7258",
            "fax_number": "702-454-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6839 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171635",
            "telephone_number": "702-737-7258",
            "fax_number": "702-454-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL JAYNE MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "JAYNE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-737-7258",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NV",
            "license": "9106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA5010",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018156",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Retina Center at Las Vegas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Retina Center at Las Vegas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason Rusk, PA-C
• Andrew Russ
• Tiffany Nichole Russaw, APRN
• Jon Richard Russe
• Russell J. Shah MD LTD
• Angela Russell- Gibbon
• Amber Russell
• Ashley Y Russell
• Betty Grace Russell, LCSW
• Briana Russell

• Ophthalmology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ophthalmology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.