Dr Charles E Russell, MD is a medicare enrolled "Preventive Medicine - Addiction Medicine" physician in Waynesville, Ohio. His current practice location is
415 S Main St, Waynesville, Ohio. You can reach out to his office (for appointments etc.) via phone at
(513) 897-7162.
Dr Charles E Russell is licensed to practice in Ohio (license number 35050063) 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 1245220912.
Physician's Profile
| Full Name | Dr Charles E Russell |
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| Gender | Male |
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| Speciality | Preventive Medicine - Addiction Medicine |
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| Location | 415 S Main St, Waynesville, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1245220912
- Provider Enumeration Date: 10/25/2005
- Last Update Date: 07/23/2024
Medicare PECOS Information:
- PECOS PAC ID: 3577450394
- Enrollment ID: I20180315000606
Medical Identifiers
Medical identifiers for Dr Charles E Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245220912 | NPI | - | NPPES |
| 000000546225 | Other | OH | ANTHEM |
| 0573348 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2083A0300X | Preventive Medicine - Addiction Medicine | 35050063 (Ohio) | 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. Dr Charles E Russell allows following entities to bill medicare on his behalf.
| Entity Name | Access Behavioral Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437463213
PECOS PAC ID: 1052595402
Enrollment ID: O20110408000052 |
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| Entity Name | Access Ohio Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689763740
PECOS PAC ID: 4385899053
Enrollment ID: O20130612000051 |
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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. Dr Charles E 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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Dr Charles E Russell, MD
3195 Dayton Xenia Rd # 900-162,
Beavercreek, OH 45434-6390
Ph: (937) 718-7677 | Dr Charles E Russell, MD
415 S Main St,
Waynesville, OH 45068-9553
Ph: (513) 897-7162 |
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