Robert Russow, MA, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

11490 Braddock Dr
Culver City, CA 90230-5151

Phone

(708) 351-3092

NPI assigned

May 26, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Evolve Occupational & Physical Therapy P.C.

  • Physical Therapy Clinic/Center
  • Culver City, CA
  • NPI 1043626724
  NPD (past)

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1790164507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11490 BRADDOCK DR",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902305151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11490 BRADDOCK DR",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902305151",
            "telephone_number": "708-351-3092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSOW",
        "first_name": "ROBERT",
        "credential": "MA, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sergio A Ruiz
• Frederick Rule, M.A.
• Chizelle Rush, MD
• Jordan E Rush
• Hubert Anthony Russell, M.D.
• Nilufer S Rustomji, PA
• Derrick Rutledge
• Sophia Ruvalcaba
• RW McComb Dental Corp
• RW McComb Dental Corp

• Occupational Therapist in Culver City, CA
• Providers in Culver City, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.