Individual provider Active NPI

Russel H York, MD

  • Rheumatology Physician
  • Detroit, MI
National Provider Identifier
1912096744
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
4301043619 Issued in MI
Practice address
4160 John R St
Suite 917
Detroit, MI 48201-2020
Phone
(313) 745-4525
Fax
(313) 745-0011
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301043619 MI
Rheumatology Physician 207RR0500X 4301043619 MI Primary

Addresses

Primary practice location

4160 John R St
Suite 917
Detroit, MI 48201-2020

Mailing address

400 Mack Ave
Detroit, MI 48201-2136

Other practice location 1

400 Mack Ave
Detroit, MI 48201-2136
Phone (313) 448-9650

Other practice location 2

26400 W 12 Mile Rd Ste 145
Southfield, MI 48034-1700
Phone (248) 359-8034

Other identifiers 1

IdentifierTypeStateIssuer
1943271MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20061214000371 MI Practitioner - RheumatologyPractitioner - Internal Medicine 9234138538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Howard University College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

4160 John R St
Suite 917
Detroit, MI 48201-2017
Phone (313) 745-7227

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Joshua P June DO Rheumatology PastSince Mar 22, 2020 Accepting new patients
University Physician Group Past Accepting new patients

Locations

400 Mack Ave
Detroit, MI 48201
Phone (313) 448-9006

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

4160 John R St
Ste 917
Detroit, MI 48201
Phone (313) 745-1445

26400 W 12 Mile Rd
Ste 111
Southfield, MI 48034
Phone (248) 357-4151

26400 W 12 Mile Rd
Ste 145
Southfield, MI 48034
Phone (248) 359-8034

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

1560 E Maple Rd
Ste 400
Troy, MI 48083

Interoperability endpoints

  • Direct secure messaging: ryork@direct.dmc.org
  • Direct secure messaging: russel.york.1@19711.direct.athenahealth.com

Organizations & group practices 3

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 2

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1912096744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "SUITE 917",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020",
            "telephone_number": "313-745-4525",
            "fax_number": "313-745-0011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Mack Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012136",
            "country_code": "US",
            "telephone_number": "313-448-9650",
            "fax_number": "313-448-9979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26400 W 12 Mile Rd Ste 145",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480341700",
            "country_code": "US",
            "telephone_number": "248-359-8034",
            "fax_number": "248-359-8660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YORK",
        "first_name": "RUSSEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301043619",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301043619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1943271",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.