Tara Mary Russian, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P059328 Issued in NY

Practice address

80TH St & 41St Ave
Elmhurst, NY 11373-1329

Phone

(718) 334-3900

Fax

(718) 334-5958

NPI assigned

Dec 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Clinical Social Worker

Education

New York University Medical College - NLG, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All-American Counseling WellnessGroup PAC ID 1850651076, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• All-American Counseling Wellness

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1104337625
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720144728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "address_2": "MANAGED CARE, D1-01",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-1921",
            "fax_number": "718-334-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80TH ST & 41ST AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-3900",
            "fax_number": "718-334-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSIAN",
        "first_name": "TARA",
        "middle_name": "MARY",
        "name_prefix": "Miss",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "P059328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asher Rubinov, DDS
• Tsipora Rubinov, DDS
• David D. Rubinstein, M.D.
• Jesus Javier Rubio Castillon, MD
• Kristi Lauren Ruggiero, PA
• Masood Rustemi
• Jurij Rybak, MD
• Peter Rybakov
• S.K. Bhuiyan Physician, PC
• S&N Pharmacy Corp

• Clinical Social Worker in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.