Alex Russell, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in New York, New York. His current practice location is
622 W 168th St Ph 5-133, New York, New York. You can reach out to his office (for appointments etc.) via phone at
(212) 305-3226.
Alex Russell is licensed to practice in * (Not Available) (license number ) 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 1417585423.
Physician's Profile
| Full Name | Alex 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 | 622 W 168th St Ph 5-133, New York, New York |
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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: 1417585423
- Provider Enumeration Date: 03/27/2020
- Last Update Date: 10/08/2024
Medicare PECOS Information:
- PECOS PAC ID: 5698214070
- Enrollment ID: I20241015001212
Medical Identifiers
Medical identifiers for Alex Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1417585423 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207L00000X | Anesthesiology | A194390 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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. Alex Russell allows following entities to bill medicare on his behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
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| Entity Name | University Of California San Francisco |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861578973 PECOS PAC ID: 4486567229 Enrollment ID: O20031212000897 |
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| Entity Name | University Anesthesia Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1528137296 PECOS PAC ID: 2769370535 Enrollment ID: O20040304001219 |
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| Entity Name | Ucsf Medical Group Business Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477624104 PECOS PAC ID: 3779497870 Enrollment ID: O20040622001513 |
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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. Alex 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 |
Alex Russell, 513 Parnassus Ave, San Francisco, CA 94143-2205 Ph: (415) 335-1297 | Alex Russell, 622 W 168th St Ph 5-133, New York, NY 10032-3720 Ph: (212) 305-3226 |
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