Michael David Russell, MD, MBA, MPH

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

License

W6372 Issued in TX

Practice address

1131 Wilshire Blvd Ste 100
Santa Monica, CA 90401-2072

Phone

(310) 319-3475

NPI assigned

Apr 10, 2018

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Pediatric MedicineAlso: Orthopedic Surgery

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.27 of 100Reported as group

Quality

80.41

Promoting interoperability

100

Improvement activities

40

Cost

68.99

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Covenant Medical Group

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1376598904

  Orthopaedic Surgery

  Medicare reassignment NPD

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1710484472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 WILSHIRE BLVD STE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012072",
            "telephone_number": "310-319-3475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4102 24th St Ste 506",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794101805",
            "country_code": "US",
            "telephone_number": "806-725-7980",
            "fax_number": "806-723-7985",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 15th St Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041101",
            "country_code": "US",
            "telephone_number": "310-319-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 16th St Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041249",
            "country_code": "US",
            "telephone_number": "310-319-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "MD, MBA, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "TX",
            "license": "W6372",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A185250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Anne Rummell
• Bruce A. Rush, PSY.D.
• Russ T Shimizu, M.D., Inc.
• Alex Jules Russan, LMFT
• Margaret Louise Russell, PH.D.
• Megan Rustad, DDS
• Christopher Harrison Ruth, DAOM, LAC
• Ann Ita Ryan, MD
• Elizabeth Ryan, PH.D.
• S. Murad M.D., Inc.

• Pediatric Orthopaedic Surgery Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Pediatric Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.