Joseph Michael John Russell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2830 Crescent Ave
Eugene, OR 97408-7397

Phone

(541) 686-9000

Fax

(541) 242-4585

NPI assigned

Nov 30, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Oregon Healthcare Resources, LLC

  • Multi-Specialty Clinic/Center
  • Eugene, OR
  • NPI 1982907572
  Medicare reassignment NPD
• Oregon Healthcare Resources, LLC

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1215761002
  NPD

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

{
    "created_epoch": "1354233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1730424805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1648",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974401648",
            "telephone_number": "541-686-9000",
            "fax_number": "541-242-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 CRESCENT AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087397",
            "telephone_number": "541-686-9000",
            "fax_number": "541-242-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL JOHN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-30",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500654869",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Autumn Starr Russell, CADC II, QMHA I
• Christi M Russell, SMC FCDBC
• Conner Jackson Russell
• Erin Amelia Russell, M.ED.
• Jennifer Marie Russell
• Kelly Hanh Russell, PA-C
• Marie Christine Russell
• Nicholas Joseph Russo
• Sarah Russo, RN IBCLC
• Robert Glen Rust Jr., D.M.D.

• Physician Assistant in Eugene, OR
• Providers in Eugene, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.