Individual provider Active NPI

Kristy K Russ

  • Nurse Practitioner
  • New Hartford, NY
National Provider Identifier
1962921809
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
308414 Issued in NY
Practice address
8411 Seneca Tpke
New Hartford, NY 13413-4912
Phone
(315) 624-8500
Fax
(315) 624-8515
NPI assigned
Sep 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 308414 NY Primary

Addresses

Primary practice location

8411 Seneca Tpke
New Hartford, NY 13413-4912

Mailing address

2209 Genesee Street
Business Office Room 310
Utica, NY 13501-5930
Phone (315) 801-3282

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180725000036 NY Practitioner - Nurse Practitioner 3476800228 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rome Memorial Hospital, Inc.Group PAC ID 9638087273, 56 clinicians

Practice addresses (Care Compare)

1500 N James St
Rome, NY 13440-2844
Phone (315) 338-7021

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Jul 5, 2018 Accepting new patients
Rome Memorial Hospital, Inc CurrentSince Jan 1, 2023 Accepting new patients
MVHS Inc CurrentSince Jul 5, 2018 Accepting new patients
Rome Memorial Hospital, Inc. Current Accepting new patients
Rome Memorial Hospital, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Rome Memorial Hospital, Inc. Past Accepting new patients

Locations

8411 Seneca Tpke
New Hartford, NY 13413
Phone (315) 624-8500

107 E Chestnut St
Ste 102
Rome, NY 13440
Phone (315) 338-9200

1500 N James St
Rome, NY 13440
Phone (315) 338-7000

2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

Interoperability endpoints

  • Direct secure messaging: kruss@rmhclinics.medentdirect.com
  • Direct secure messaging: kruss@rmh.medalliesdirect.net

Organizations & group practices 6

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 8

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": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1962921809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 GENESEE STREET",
            "address_2": "BUSINESS OFFICE ROOM 310",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015930",
            "telephone_number": "315-801-3282",
            "fax_number": "315-801-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8411 SENECA TPKE",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134134912",
            "telephone_number": "315-624-8500",
            "fax_number": "315-624-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "KRISTY",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "308414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

Verify at the official NPI Registry.