Russell D Donnelly, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

56088 Issued in MA

Practice address

94 South St
Southbridge, MA 01550-4000

Phone

(508) 764-2772

Fax

(508) 764-2833

NPI assigned

Oct 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Orthopedic Surgery

Education

Johns Hopkins University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Umass Memorial Health - Harrington Hospital Hospital, Southbridge, MA, CCN 220019

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

82.98

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rdonnelly343278@direct.mmc.mainehealth.org
• Direct secure messaging: russelldonnelly@hps.allscriptsdirect.net

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.

• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Henry Heywood Memorial Hospital

  • General Acute Care Hospital
  • Gardner, MA
  • NPI 1205823879
  Medicare reassignment NPD
• Holyoke Medical Center, Inc.

  • General Acute Care Hospital
  • Holyoke, MA
  • NPI 1750395737
  Medicare reassignment NPD
• Heywood Medical Group Inc.

  • General Practice Physician
  • Gardner, MA
  • NPI 1699762286
  Medicare reassignment
• Henry Heywood Memorial Hospital

  • Psychiatric Hospital Unit
  • Gardner, MA
  • NPI 1457685299
  NPD
• Umass Memorial Medical Group, Inc.

  • Urgent Care Clinic/Center
  • Oxford, MA
  • NPI 1982381018
  NPD
• Paul a. Cournoyer D.P.M., P.C.

  • Foot Surgery Podiatrist
  • Worcester, MA
  • NPI 1598779860
  NPD (past)
• Umass Memorial Health-Harrington Hospital Inc

  • General Acute Care Hospital
  • Southbridge, MA
  • NPI 1790780047
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Umass Memorial Health-Harrington Hospital Inc

  • General Acute Care Hospital
  • Southbridge, MA
  • NPI 1790780047
  Care Compare affiliation

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1780672105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015500040",
            "telephone_number": "508-909-7799",
            "fax_number": "508-764-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 SOUTH ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015504000",
            "telephone_number": "508-764-2772",
            "fax_number": "508-764-2833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3073 White Mountain Hwy",
            "address_purpose": "LOCATION",
            "city": "North Conway",
            "state": "NH",
            "postal_code": "038607101",
            "country_code": "US",
            "telephone_number": "603-356-5461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "RUSSELL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NH",
            "license": "LT-3003",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ME",
            "license": "MD19308",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "56088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780672105",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nizam Ud Din
• Eve Marie Dipietro
• Karen R. Distefano
• Craig M Dolphin, MSW, MPS
• Donald J Gentile MD PC
• Vivian Marrero Doros, LCSW
• Deborah Dostal, RN
• Ana Maria Dragoiescu, DNP
• Laurie J. Dunleavy, LMHC
• William Francis Dunn, D.O.

• Orthopaedic Surgery Physician in Southbridge, MA
• Providers in Southbridge, MA by specialty
• Orthopaedic Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.