Individual provider Active NPI

Troy S Russon, MD

  • Anesthesiology Physician
  • Bismarck, ND
National Provider Identifier
1790977957
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
11486 Issued in ND
Practice address
310 N 10TH St
Bismarck, ND 58501-4516
Phone
(701) 530-7500
Fax
(701) 530-7484
NPI assigned
Aug 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 11486 ND Primary

Addresses

Primary practice location

310 N 10TH St
Bismarck, ND 58501-4516

Mailing address

310 N 10TH St
Bismarck, ND 58501-4516
Phone (701) 530-7500

Other identifiers 3

IdentifierTypeStateIssuer
100498200MedicaidMN
ENROLLEDMedicaidIA
35112600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100922000997 ND Practitioner - Anesthesiology 9931291945 Reassigns benefits to 1 organization
I20241223001762 AR Practitioner - Anesthesiology 9931291945 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Virginia School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 338-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.63 of 100Reported as group
Quality
89.39
Promoting interoperability
100
Improvement activities
40
Cost
76.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11486NDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services of Benton County PA Anesthesiology CurrentSince Nov 25, 2024 Accepting new patients
St Alexius Medical Center CurrentSince Sep 12, 2015 Accepting new patients
St. Alexius Medical Center CurrentSince Sep 12, 2015 Accepting new patients
Renew Medical Group of Arkansas LTD Anesthesiology CurrentSince Feb 1, 2025 Accepting new patients

Locations

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

2708 S Rife Medical Ln
Ste 300
Rogers, AR 72758
Phone (479) 338-3030

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

310 N 10th St
Bismarck, ND 58501
Phone (701) 530-7500

401 N 9th St
Bismarck, ND 58501
Phone (701) 530-6000

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

Organizations & group practices 4

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 1

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": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1790977957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N 10TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014516",
            "telephone_number": "701-530-7500",
            "fax_number": "701-530-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N 10TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014516",
            "telephone_number": "701-530-7500",
            "fax_number": "701-530-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSON",
        "first_name": "TROY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ND",
            "license": "11486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100498200",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35112600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.