Individual provider Active NPI

Michael Edward Russell II, MD

  • Orthopaedic Surgery of the Spine Physician
  • Tyler, TX
National Provider Identifier
1720076052
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
J2290 Issued in TX
Practice address
3414 Golden Rd
Tyler, TX 75701-8336
Phone
(903) 939-7500
Fax
(903) 939-7728
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X J2290 TX
Orthopaedic Surgery of the Spine Physician 207XS0117X J2290 TX Primary

Addresses

Primary practice location

3414 Golden Rd
Tyler, TX 75701-8336

Mailing address

PO Box 130189
Tyler, TX 75713-0189
Phone (903) 939-7500

Other practice location 1

3816 N University Dr
Nacogdoches, TX 75965-2011
Phone (903) 939-7500

Other practice location 2

305 W 20th St
MT Pleasant, TX 75455-2327
Phone (903) 939-7500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100715000364 TX Practitioner - Orthopedic Surgery 0042244915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Texas Southwestern Medical School at Dallas, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortholonestar PLLCGroup PAC ID 9931529062, 416 clinicians

Practice addresses (Care Compare)

305 W 20TH St
Mount Pleasant, TX 75455-2327
Phone (903) 939-7500

3414 Golden Rd
Tyler, TX 75701-8336
Phone (903) 939-7500

3800 Gaylord Pkwy
Suite 710
Frisco, TX 75034-9635
Phone (214) 220-2468

3816 N University Dr
Nacogdoches, TX 75965-2011
Phone (903) 939-7500

925 W Loop
Suite 281
Longview, TX 75604-2918
Phone (903) 939-7500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as individual
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion484
Laminectomy or laminotomy (partial removal of spine bones)182

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J2290TXMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Orthopedics Sports & Rehabilitation Associates PA Orthopaedic Surgery CurrentSince Dec 1, 2023 Accepting new patients
Ortholonestar, PLLC Orthopaedic Surgery CurrentSince Oct 1, 2020 Accepting new patients
Ortholonestar, PLLC Orthopaedic Surgery CurrentSince Oct 1, 2020 Accepting new patients
East Texas Medical Center Past Accepting new patients

Locations

3755 S Capital of Texas Hwy
Ste 130
Austin, TX 78704
Phone (512) 439-1005

2635 W Baker Rd
Baytown, TX 77521
Phone (281) 337-8550

9301 N Central Expy
Ste 451
Dallas, TX 75231
Phone (214) 397-1570

3800 Gaylord Pkwy
Ste 710
Frisco, TX 75034

925 W Loop 281
Longview, TX 75604
Phone (430) 240-6029

305 W 20th St
Mt Pleasant, TX 75455
Phone (903) 572-2222

3816 N University Dr
Nacogdoches, TX 75965
Phone (936) 305-5301

10223 Broadway St
Ste A
Pearland, TX 77584
Phone (713) 436-3488

3414 Golden Rd
Tyler, TX 75701
Phone (903) 590-3050

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.

Hospital & facility affiliations 4

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1720076052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130189",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757130189",
            "telephone_number": "903-939-7500",
            "fax_number": "903-939-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 GOLDEN RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018336",
            "telephone_number": "903-939-7500",
            "fax_number": "903-939-7728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3816 N University Dr",
            "address_purpose": "LOCATION",
            "city": "Nacogdoches",
            "state": "TX",
            "postal_code": "759652011",
            "country_code": "US",
            "telephone_number": "903-939-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 W 20th St",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "TX",
            "postal_code": "754552327",
            "country_code": "US",
            "telephone_number": "903-939-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "J2290",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TX",
            "license": "J2290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.