Individual provider Active NPI

Morgan Russek

  • Family Medicine Physician
  • Mora, MN
National Provider Identifier
1942996491
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
77957 Issued in MN
Practice address
301 Highway 65 S
Mora, MN 55051-1899
Phone
(320) 679-1313
NPI assigned
Apr 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 77957 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

301 Highway 65 S
Mora, MN 55051-1899

Mailing address

301 Highway 65 S
Mora, MN 55051-1899
Phone (320) 679-1313

Other practice location 1

6600 Excelsior Blvd Ste 160
St Louis Park, MN 55426-4713
Phone (952) 993-7705

Other practice location 2

3850 Park Nicollet Blvd
Saint Louis Park, MN 55416-2527
Phone (952) 993-9840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20260320002329 MN Practitioner - Family Practice 8527420694 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

301 Hwy 65 S
Mora, MN 55051-1899

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-1614

PO Box
1309 Ms 21110Q
Minneapolis, MN 55440-1309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33703MNMDNeurology with Special Qualifications in Child Neurology Physician

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.

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1942996491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HIGHWAY 65 S",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511899",
            "telephone_number": "320-679-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HIGHWAY 65 S",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511899",
            "telephone_number": "320-679-1313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 Excelsior Blvd Ste 160",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554264713",
            "country_code": "US",
            "telephone_number": "952-993-7705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3850 Park Nicollet Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis Park",
            "state": "MN",
            "postal_code": "554162527",
            "country_code": "US",
            "telephone_number": "952-993-9840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSEK",
        "first_name": "MORGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "77957",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mora, MN

Sources for this page

Verify at the official NPI Registry.