Daniel Russell

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

78 Beaver St
Brooklyn, NY 11206-4504

Phone

(718) 406-6037

NPI assigned

May 18, 2021

Last updated

May 31, 2021By the provider in NPPES

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

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • NPI 1891702742
  Medicare reassignment
• Physical Medicine and Rehabilitation Mobile PC

  • Physical Medicine & Rehabilitation Physician
  • Atlantic Beach, NY
  • NPI 1093540163
  Medicare reassignment
• Green Rehabilitation Medicine

  • Physical Medicine & Rehabilitation Physician
  • Brooklyn, NY
  • NPI 1144930611
  NPD (past)

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622419200000",
    "number": "1760056238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CARMITA AVE",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070701654",
            "telephone_number": "201-414-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 BEAVER ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112064504",
            "telephone_number": "718-406-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-31",
        "certification_date": "2021-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arianna Russell
• Bridget Russell
• Candice Russell
• Christopher Paul Russell, MS. ED., TVI
• Cynthia Russell, RPAC
• Felicia Marie Russell, LMT
• Frazier Russell
• Garthisha Russell
• Kelli Ann Russell
• Keon J Russell, MS.ED

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2021; 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.