Individual provider Active NPI

Russell J Hibler, PHD

  • Cognitive & Behavioral Psychologist
  • Crofton, MD
National Provider Identifier
1700842903
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
01803 Issued in MD
Practice address
1589 Eton Way
Crofton, MD 21114-1524
Phone
(410) 244-0227
Fax
(866) 695-6454
NPI assigned
Apr 25, 2006
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 01803 MD Primary

Addresses

Primary practice location

1589 Eton Way
Crofton, MD 21114-1524

Mailing address

1589 Eton Way
Crofton, MD 21114-1524
Phone (410) 244-0227

Other identifiers 1

IdentifierTypeStateIssuer
229951800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080305000061 MD Practitioner - Clinical Psychologist 0547345324 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1589 Eton Way
Crofton, MD 21114-1524
Phone (410) 244-0227

7920 McDonogh Rd
Suite 201
Owings Mills, MD 21117-5323
Phone (410) 571-2946

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01803MDMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Management Specialists, LLC CurrentSince Feb 10, 2018 Accepting new patients
Russell James Group, P.a. CurrentSince Mar 8, 2013 Accepting new patients
Advanced Pain Management Specialists, LLC CurrentSince Feb 10, 2018 Accepting new patients
Advanced Pain Management Specialists, LLC Past Accepting new patients

Locations

810 Bestgate Rd
Ste 220
Annapolis, MD 21401
Phone (800) 997-2460

857 Park Ave
Baltimore, MD 21201
Phone (410) 244-6633

6602 Church Hill Rd
Ste 550
Chestertown, MD 21620

1576 Merritt Blvd
Ste 18
Dundalk, MD 21222
Phone (443) 530-9750

598 Cynwood Dr
Ste 105
Easton, MD 21601
Phone (410) 822-1221

19851 Observation Dr
Ste 360
Germantown, MD 20876

7671 Quarterfield Rd
Ste 301
Glen Burnie, MD 21061
Phone (410) 457-3041

23000 Moakley St
Ste 206
Leonardtown, MD 20650
Phone (301) 475-5855

8100 Sandpiper Cir
Ste 214
Nottingham, MD 21236
Phone (443) 442-0500

7920 McDonogh Rd
Ste 201
Owings Mills, MD 21117
Phone (443) 321-2590

120 Sallitt Dr
#D
Stevensville, MD 21666
Phone (410) 923-2714

6569 N Charles St
Ste 500
Towson, MD 21204
Phone (410) 296-6090

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1700842903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 ETON WAY",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141524",
            "telephone_number": "410-244-0227",
            "fax_number": "866-695-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1589 ETON WAY",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141524",
            "telephone_number": "410-244-0227",
            "fax_number": "866-695-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBLER",
        "first_name": "RUSSELL",
        "middle_name": "J",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MD",
            "license": "01803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "229951800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

Verify at the official NPI Registry.