Individual provider Active NPI

Marika Dubin Russell, M.D.

  • Otolaryngology Physician
  • Boston, MA
National Provider Identifier
1730352899
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
1019587 Issued in MA
Practice address
243 Charles St
Boston, MA 02114-3096
Phone
(617) 573-3654
NPI assigned
Apr 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 1019587 MA Primary

Addresses

Primary practice location

243 Charles St
Boston, MA 02114-3096

Mailing address

243 Charles St
Boston, MA 02114-3096
Phone (617) 573-4115

Other practice location 1

101 Main St Ste 211
Medford, MA 02155-4530
Phone (781) 874-1965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240703002772 MA Practitioner - Otolaryngology 1355527482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Columbia University College of Physicians and Surgeons, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Massachusetts Eye and Ear Associates, IncGroup PAC ID 4486540275, 430 clinicians

Practice addresses (Care Compare)

243 Charles St
Boston, MA 02114-3002
Phone (617) 523-7900

Hospital & facility affiliations

  • Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Eye and Ear Associates, Inc. Otolaryngology CurrentSince Aug 1, 2024 Accepting new patients

Locations

243 Charles St
Boston, MA 02114
Phone (617) 523-7900

101 Main St
Ste 211
Medford, MA 02155
Phone (781) 395-7304

300 Crown Colony Dr
Ste 201
Quincy, MA 02169
Phone (617) 573-3135

Organizations & group practices 1

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 2

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": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1730352899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143096",
            "telephone_number": "617-573-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143096",
            "telephone_number": "617-573-3654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Main St Ste 211",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "MA",
            "postal_code": "021554530",
            "country_code": "US",
            "telephone_number": "781-874-1965",
            "fax_number": "781-874-1967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MARIKA",
        "middle_name": "DUBIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "1019587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.