Andrew Russell, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0068003 Issued in CO

Practice address

925 2ND Ave
Monte Vista, CO 81144-1432

Phone

(719) 852-2512

Fax

(719) 852-3923

NPI assigned

Apr 20, 2015

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 CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrew.russell.p1@direct.vwhs.nextgenshare.com

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.

• Valley-Wide Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
  • NPI 1790998953
  NPD
• Valley-Wide Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
  • NPI 1205652047
  NPD
• South Central Colfax County Special Hospital District

  • Urgent Care Clinic/Center
  • Angel Fire, NM
  • NPI 1487470977
  NPD (past)

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

• Lutheran Hospital Association of the San Luis Valley

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744

  Hospital

  Care Compare affiliation
• Valley Citizens' Foundation for Health Care Inc

  • Critical Access Hospital
  • Del Norte, CO
  • NPI 1396783981

  Hospital

  Care Compare affiliation
• Valley Citizens' Foundation for Health Care Inc

  • Critical Access Hospital Clinic/Center
  • South Fork, CO
  • NPI 1699266718

  Hospital

  Care Compare affiliation
• Valley Citizens' Foundation for Health Care Inc

  • Critical Access Hospital Clinic/Center
  • Creede, CO
  • NPI 1851882989

  Hospital

  Care Compare affiliation

Specialty

Family Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley-Wide Health Systems, Inc. 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Luis Valley Regional Medical Center Hospital, Alamosa, CO, CCN 060008
• Rio Grande Hospital Hospital, Del Norte, CO, CCN 061301

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1669869558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 2ND AVE",
            "city": "MONTE VISTA",
            "state": "CO",
            "postal_code": "811441432",
            "telephone_number": "719-852-2512",
            "fax_number": "719-852-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 2ND AVE",
            "city": "MONTE VISTA",
            "state": "CO",
            "postal_code": "811441432",
            "telephone_number": "719-852-2512",
            "fax_number": "719-852-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ANDREW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-20",
        "last_updated": "2022-03-08",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "0068003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "0068003",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard D. Santi, D.D.S., P.C.
• RMHG LTD
• Brian Mark Roberts, DDS
• Rock Creek Rehabilitation and Healthcare Center LLC
• Rock Creek Rehabilitation and Healthcare Center LLC
• Bryan J. Salazar, R.PH.
• San Juan Youth Works
• San Luis Valley Community Mental Health Center
• San Luis Valley Community Mental Health Center
• San Luis Valley Community Mental Health Center

• All providers in Monte Vista, CO
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.