Active NPI
Russell Frederick Trahan
- Foot & Ankle Surgery Podiatrist
- New York, NY
National Provider Identifier
1710934682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 003996
- Practice address
- 247 W 145TH St
New York, NY 10039-4004 - Phone
- (212) 281-9300
- Fax
- (212) 491-7984
- NPI assigned
- May 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 003996 | NY | Primary |
Addresses
Primary practice location
247 W 145TH St
New York, NY 10039-4004
Mailing address
250 W 90TH St
Ph2A
New York, NY 10024-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 480005657 | Other | NY | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- New York College of Podiatric Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2015 Grand Concourse
Bronx, NY 10453-4303
Phone (718) 299-7295
Hospital & facility affiliations
- Revival Home Health Care
- St Barnabas Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 735 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 986 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 14 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003996 | NY | MD | Foot & Ankle Surgery Podiatrist |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Interoperability endpoints
- rtrahan19828@sbhny.direct-ci.net
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 and National Provider Directory roles.
-
- Legal Medicine
- Bronx, NY
- NPI 1366418709
-
- Internal Medicine Physician
- Bronx, NY
- NPI 1356726087
-
- Urgent Care Clinic/Center
- Bronx, NY
- NPI 1841607298
-
- Internal Medicine Physician
- Bronx, NY
- NPI 1851345946
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Staten Island, NY
- NPI 1841233178
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1548367873
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340841600000",
"number": "1710934682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 W 90TH ST",
"address_2": "PH2A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100241100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "247 W 145TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100394004",
"telephone_number": "212-281-9300",
"fax_number": "212-491-7984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAHAN",
"first_name": "RUSSELL",
"middle_name": "FREDERICK",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-27",
"last_updated": "2012-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NY",
"license": "003996",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "480005657",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.