Andrew John Russell, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Kalamazoo, Michigan. His current practice location is
1000 Oakland Dr, Kalamazoo, Michigan. You can reach out to his office (for appointments etc.) via phone at
(269) 337-4400.
Andrew John Russell is licensed to practice in Michigan (license number 4301096784) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1104147800.
Physician's Profile
Full Name | Andrew John Russell |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1000 Oakland Dr, Kalamazoo, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1104147800
- Provider Enumeration Date: 06/16/2010
- Last Update Date: 06/16/2010
Medicare PECOS Information:
- PECOS PAC ID: 5294979001
- Enrollment ID: I20130918000095
Medical Identifiers
Medical identifiers for Andrew John Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104147800 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | 4301096784 (Michigan) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | 4301096784 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Andrew John Russell allows following entities to bill medicare on his behalf.
Entity Name | Alegent Creighton Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1548287907 PECOS PAC ID: 1951210418 Enrollment ID: O20040407001314 |
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Entity Name | Epn Of Nebraska Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1205382264 PECOS PAC ID: 3375830623 Enrollment ID: O20160929002071 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Andrew John Russell is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Andrew John Russell, MD 1000 Oakland Dr, Kalamazoo, MI 49008-1282 Ph: (269) 337-4400 | Andrew John Russell, MD 1000 Oakland Dr, Kalamazoo, MI 49008-1282 Ph: (269) 337-4400 |
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