NPIMap

Individual provider Active NPI

Russell A Mounts, PA-C

  • Surgical Physician Assistant
  • Akron, OH
National Provider Identifier
1790865749
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.000600RX Issued in OH
Practice address
3975 Embassy Pkwy
Akron, OH 44333-8320
Phone
(330) 668-4040
Fax
(330) 668-4078
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.000600RX OH Primary

Addresses

Primary practice location

3975 Embassy Pkwy
Akron, OH 44333-8320

Mailing address

3975 Embassy Pkwy
Akron, OH 44333-8320
Phone (330) 668-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100319000114 OH Practitioner - Physician Assistant 5991830648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crystal Clinic, Inc.Group PAC ID 7214821586, 46 clinicians

Practice addresses (Care Compare)

2007 State Route 59
Kent, OH 44240-7610
Phone (330) 673-6299

3975 Embassy Pkwy
Suite 202
Akron, OH 44333-8395
Phone (330) 668-4085

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as group
Quality
83.94
Promoting interoperability
100
Improvement activities
40
Cost
78.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.000600RXOHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Clinic Inc CurrentSince Jan 1, 1996 Accepting new patients
Crystal Clinic Orthopaedic Center LLC CurrentSince Jan 1, 2017 Accepting new patients
Crystal Clinic Orthopaedic Center LLC Surgical CurrentSince Jan 1, 2017 Accepting new patients
Crystal Clinic Orthopaedic Center, LLC Past Accepting new patients

Locations

3975 Embassy Pkwy
Akron, OH 44333
Phone (330) 670-4242

3975 Embassy Pkwy
Ste 202
Akron, OH 44333
Phone (330) 668-4085

4466 Fulton Dr NW
Canton, OH 44718
Phone (330) 489-1386

437 Portage Trl
Cuyahoga Fls, OH 44221
Phone (330) 929-9136

3557 Embassy Pkwy
Fairlawn, OH 44333
Phone (330) 670-1005

1622 E Turkeyfoot Lake Rd
Ste 201
Green, OH 44312
Phone (330) 776-4440

1622 E Turkeyfoot Lake Rd
Ste 200
Green, OH 44312
Phone (330) 644-7436

2007 State Route 59
Kent, OH 44240
Phone (330) 673-1904

Organizations & group practices 5

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 12

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1790865749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 EMBASSY PKWY",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443338320",
            "telephone_number": "330-668-4040",
            "fax_number": "330-668-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 EMBASSY PKWY",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443338320",
            "telephone_number": "330-668-4040",
            "fax_number": "330-668-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUNTS",
        "first_name": "RUSSELL",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.000600RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.