Individual provider Active NPI

De Ante Russ

  • Emergency Medicine Physician
  • Toledo, OH
National Provider Identifier
1811423502
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.135938 Issued in OH
Practice address
3000 Arlington Ave
Toledo, OH 43614-2595
Phone
(330) 388-7856
NPI assigned
May 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Emergency Medicine Physician 207P00000X 35.135938 OH Primary

Addresses

Primary practice location

3000 Arlington Ave
Toledo, OH 43614-2595

Mailing address

2149 Evergreen Rd Apt 2
Ottawa Hills, OH 43606-2547
Phone (330) 388-7856

Other practice location 1

4065 Center Rd
Brunswick, OH 44212-2918
Phone (330) 558-0123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, TN2 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
I20190730003361 OH Practitioner - Emergency Medicine 4385970250 Reassigns benefits to 4 organizations
I20200721001708 TN Practitioner - Emergency Medicine 4385970250

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lorain Emergency Physicians LLCGroup PAC ID 0244605608, 16 clinicians
Emergency Professional Services, Inc.Group PAC ID 7214832435, 121 clinicians

Practice addresses (Care Compare)

3700 Kolbe Rd
Lorain, OH 44053-1611
Phone (440) 960-4000

615 Fulton St
Port Clinton, OH 43452-2001
Phone (419) 734-3131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.39 of 100Reported as group
Quality
69.41
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.135938OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Lorain Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince May 1, 2025 Accepting new patients
Ashland Emergency Group LLC Emergency Medicine CurrentSince Dec 19, 2022 Accepting new patients

Locations

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

1600 E Riverview Ave
Napoleon, OH 43545
Phone (260) 344-3045

200 W Lorain St
Oberlin, OH 44074
Phone (440) 775-1211

615 Fulton St
Port Clinton, OH 43452
Phone (419) 734-3131

885 N Sandusky Ave
Upper Sandusky, OH 43351
Phone (419) 294-4991

Interoperability endpoints

  • Direct secure messaging: druss942572@direct.bsmhealth.org

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 3

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": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1811423502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 EVERGREEN RD APT 2",
            "city": "OTTAWA HILLS",
            "state": "OH",
            "postal_code": "436062547",
            "telephone_number": "330-388-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595",
            "telephone_number": "330-388-7856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4065 Center Rd",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "OH",
            "postal_code": "442122918",
            "country_code": "US",
            "telephone_number": "330-558-0123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSS",
        "first_name": "DE ANTE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-02",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.135938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.