Individual provider Active NPI

Russell Gura, MD

  • Internal Medicine Physician
  • Englewood, NJ
National Provider Identifier
1962400119
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA067364 Issued in NJ
Practice address
25 Rockwood PL
Englewood, NJ 07631-4957
Phone
(201) 568-8130
Fax
(201) 568-2450
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA067364 NJ Primary

Addresses

Primary practice location

25 Rockwood PL
Englewood, NJ 07631-4957

Mailing address

25 Rockwood PL
Englewood, NJ 07631-4957
Phone (201) 568-8130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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
I20101210000305 NJ Practitioner - Internal Medicine 8022205475 Reassigns benefits to 1 organization
I20140724000993 NY Practitioner - Internal Medicine 8022205475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of Ny Upstate Medical University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

24 Elm St
Harrington Park, NJ 07640-1902
Phone (201) 451-1601

350 Engle S
5TH FL Room 5518
Englewood, NJ 07631-1808
Phone (201) 568-5250

350 Engle St
Englewood, NJ 07631-1808

350 Engle St Main
Suite 256
Englewood, NJ 07631-1808
Phone (201) 894-3364

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA067364NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC Internal Medicine CurrentSince Aug 1, 2012 Accepting new patients
Rockland Cardiology PC PastSince Sep 1, 2013 Accepting new patients

Locations

25 Rockwood Pl
Ste 120
Englewood, NJ 07631
Phone (201) 227-5533

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

2 Crosfield Ave
Ste 407
West Nyack, NY 10994
Phone (845) 353-5050

Interoperability endpoints

  • Direct secure messaging: rgura236687@direct.englewoodhealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1962400119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ROCKWOOD PL",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314957",
            "telephone_number": "201-568-8130",
            "fax_number": "201-568-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ROCKWOOD PL",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314957",
            "telephone_number": "201-568-8130",
            "fax_number": "201-568-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURA",
        "first_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA067364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.