Tyler William Russell, CRNA is a medicare enrolled "Anesthesiology" in Indianapolis, Indiana. He graduated from nursing school in 2020 and has 5 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Associated Anesthesiologists Of Fort Wayne Pc and his current practice location is
1701 N Senate Blvd, Indianapolis, Indiana. You can reach out to his office (for appointments etc.) via phone at
(317) 577-4200.
Tyler William Russell is licensed to practice in Indiana (license number 28211638A) 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 1447889548.
Provider's Profile
| Full Name | Tyler William Russell |
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| Gender | Male |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 5 Years |
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| Location | 1701 N Senate Blvd, Indianapolis, Indiana |
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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. |
Medical Education and Training:
- Tyler William Russell graduated from nursing school in 2020
NPI Data:
- NPI Number: 1447889548
- Provider Enumeration Date: 04/02/2020
- Last Update Date: 10/19/2022
Medicare PECOS Information:
- PECOS PAC ID: 8820411333
- Enrollment ID: I20200630002684
Medical Identifiers
Medical identifiers for Tyler William Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1447889548 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 367500000X | Nurse Anesthetist, Certified Registered | 28211638A (Indiana) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 202206135CRNA (Oregon) | Secondary |
| 207L00000X | Anesthesiology | 28211638A (Indiana) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Associated Anesthesiologists Of Fort Wayne Pc | 2264412444 | 89 |
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. Tyler William Russell allows following entities to bill medicare on his behalf.
| Entity Name | Saint Joseph Regional Medical Center-south Bend Campus Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1023844693 PECOS PAC ID: 3476451790 Enrollment ID: O20031223000724 |
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| Entity Name | Iu Anesthesiology Associates, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1285684407 PECOS PAC ID: 5395730303 Enrollment ID: O20040419001228 |
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| Entity Name | Associated Anesthesiologists Of Fort Wayne Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538159140 PECOS PAC ID: 2264412444 Enrollment ID: O20040720001562 |
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| Entity Name | Ams Northern Indiana Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1427619840 PECOS PAC ID: 8022444306 Enrollment ID: O20200205000244 |
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| Entity Name | Jebs Anesthesia Consultants, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790447761 PECOS PAC ID: 4486046646 Enrollment ID: O20220120000233 |
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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. Tyler William 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 |
Tyler William Russell, CRNA 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Tyler William Russell, CRNA 1701 N Senate Blvd, Indianapolis, IN 46202-1239 Ph: (317) 577-4200 |
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