Individual provider Active NPI

Russell Jay Laudon, M.D.

  • Family Medicine Physician
  • Elmhurst, NY
National Provider Identifier
1821084351
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
138725 Issued in NY
Practice address
5910 Junction Blvd
Elmhurst, NY 11373-5156
Phone
(718) 592-3200
Fax
(718) 592-3844
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 138725 NY Primary

Addresses

Primary practice location

5910 Junction Blvd
Elmhurst, NY 11373-5156

Mailing address

5910 Junction Blvd
Elmhurst, NY 11373-5156
Phone (718) 592-3200

Other identifiers 1

IdentifierTypeStateIssuer
00726201MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20101019000333 NY Practitioner - Internal Medicine 3779776125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Warren Alpert Medical School of Brown University, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harold Weissman MD PCGroup PAC ID 6002803533, 4 clinicians

Practice addresses (Care Compare)

5910 Junction Blvd
Elmhurst, NY 11373-5156
Phone (718) 592-3200

National Provider Directory

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

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821084351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 JUNCTION BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735156",
            "telephone_number": "718-592-3200",
            "fax_number": "718-592-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 JUNCTION BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735156",
            "telephone_number": "718-592-3200",
            "fax_number": "718-592-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUDON",
        "first_name": "RUSSELL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "138725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00726201",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.