Bryan Clint Russell, is a medicare enrolled "Physical Medicine & Rehabilitation" physician in Coronado, California. He graduated from medical school in 2018 and has 7 years of diverse experience with area of expertise as Physical Therapist In Private Practice. His current practice location is
160 C Ave, Coronado, California. You can reach out to his office (for appointments etc.) via phone at
(619) 319-5992.
Bryan Clint Russell is licensed to practice in California (license number PT295117) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1407320260.
Physician's Profile
| Full Name | Bryan Clint Russell |
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| Gender | Male |
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| Speciality | Physical Therapist In Private Practice |
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| Experience | 7 Years |
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| Location | 160 C Ave, Coronado, California |
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| Accepts Medicare Assignments | Yes. He 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:
- Bryan Clint Russell graduated from medical school in 2018
NPI Data:
- NPI Number: 1407320260
- Provider Enumeration Date: 01/15/2019
- Last Update Date: 01/15/2019
Medicare PECOS Information:
- PECOS PAC ID: 2668902859
- Enrollment ID: I20250203002414
Medical Identifiers
Medical identifiers for Bryan Clint Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1407320260 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208100000X | Physical Medicine & Rehabilitation | PT295117 (California) | 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. Bryan Clint Russell allows following entities to bill medicare on his behalf.
| Entity Name | One Life Physical Therapy Inc |
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| Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Entity Identifiers | NPI Number: 1144851361
PECOS PAC ID: 1759811946
Enrollment ID: O20250203002331 |
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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. Bryan Clint 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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Bryan Clint Russell,
6621 Archwood Ave,
San Diego, CA 92120-2401
Ph: (619) 319-5992 | Bryan Clint Russell,
160 C Ave,
Coronado, CA 92118-1420
Ph: (619) 319-5992 |
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