Individual provider Active NPI

Chelsey Russ, M.D.

  • Obstetrics & Gynecology Physician
  • Groton, CT
National Provider Identifier
1699207118
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
067559 Issued in CT
Practice address
491 Gold Star Hwy Ste 100
Groton, CT 06340-6226
Phone
(860) 445-4290
Fax
(860) 448-1368
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 067559 CT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

491 Gold Star Hwy Ste 100
Groton, CT 06340-6226

Mailing address

5 Lawrence St Unit 624
Bloomfield, NJ 07003-4671

Other practice location 1

94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone (973) 322-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20210618001651 CT Practitioner - Obstetrics/Gynecology 9133529720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians for Women'S Health, LLCGroup PAC ID 3274430665, 319 clinicians

Practice addresses (Care Compare)

103 Newtown Rd
Candlewood Center for Womens Health
Danbury, CT 06810-4195
Phone (203) 730-8789

491 Gold Star Hwy
Suite 100
Groton, CT 06340-6226
Phone (860) 445-5107

Hospital & facility affiliations

  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007

Merit-based Incentive Payment System (MIPS)

Final score
89.08 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
067559CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians for Women'S Health LLC Obstetrics & Gynecology CurrentSince Jul 15, 2021 Accepting new patients

Locations

22 Waterville Rd
Avon, CT 06001
Phone (860) 678-3461

103 Newtown Rd
Danbury, CT 06810
Phone (203) 730-8789

491 Gold Star Hwy
Ste 100
Groton, CT 06340
Phone (860) 445-4290

Interoperability endpoints

  • Direct secure messaging: chelsey.russ.1@10170.direct.athenahealth.com

Organizations & group practices 1

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 2

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1699207118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LAWRENCE ST UNIT 624",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 GOLD STAR HWY STE 100",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406226",
            "telephone_number": "860-445-4290",
            "fax_number": "860-448-1368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 Old Short Hills Rd",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070395672",
            "country_code": "US",
            "telephone_number": "973-322-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSS",
        "first_name": "CHELSEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "067559",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

Verify at the official NPI Registry.