Diane R Russell, FNP is a medicare enrolled "Nurse Practitioner" physician in Salt Lake City, Utah. She graduated from medical school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Mountainstar Cardiology St Marks Llc and her current practice location is
1160 E 3900 S Ste 2000, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 266-3418.
Diane R Russell is licensed to practice in Utah (license number 5648785-4405) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1457994089.
Physician's Profile
| Full Name | Diane R Russell |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 5 Years |
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| Location | 1160 E 3900 S Ste 2000, Salt Lake City, Utah |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Diane R Russell graduated from medical school in 2019
NPI Data:
- NPI Number: 1457994089
- Provider Enumeration Date: 10/27/2019
- Last Update Date: 02/09/2022
Medicare PECOS Information:
- PECOS PAC ID: 7315367323
- Enrollment ID: I20201013002222
Medical Identifiers
Medical identifiers for Diane R Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1457994089 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 5648785-4405 (Utah) | Secondary |
| 363L00000X | Nurse Practitioner | 5648785-4405 (Utah) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Mountainstar Cardiology St Marks Llc | 2961661855 | 32 |
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. Diane R Russell allows following entities to bill medicare on her behalf.
| Entity Name | Mountainstar Cardiology St Marks Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437446168
PECOS PAC ID: 2961661855
Enrollment ID: O20120313000497 |
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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. Diane R 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 |
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Diane R Russell, FNP
Po Box 741729,
Atlanta, GA 30374-1729
Ph: () - | Diane R Russell, FNP
1160 E 3900 S Ste 2000,
Salt Lake City, UT 84124-1236
Ph: (801) 266-3418 |
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