DR. RUSSELL E CARLSON (NPI# 1821103029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821103029 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL E CARLSON |
| Credential | M.D. |
| Practice Address |
2695 Harlem Rd Cheektowaga NY 14225-4021 |
| Practice Telephone | 7163323505 |
| Practice Fax Number | 7163323509 |
| Mailing Telephone | 7163323505 |
| Mailing Fax Number | 7163323509 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-12-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
189175 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | FIDELIS | 040426002783 | 01 |
| NY | UNIVERA HEALTHCARE | 00025759601 | 01 |
| NY | BLUE CROSS/ BLUE SHIELD | 000526654001 | 01 |
| NY | INDEPENDENT HEALTH | 2197606 | 01 |
| NY | 02212417 | 05 | |
| NY | GHI | 7099868 | 01 |
| NY | NORTH AMERICAN ADMINISTRT | PAR05802 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023271137 | Russell Martin Carlson | Podiatrist | 520 Valley View Dr, Moline, IL 61265-6152 | 2008-07-08 |
| 1659531218 | Russell Arthur Carlson | Specialist | 4800 Sand Point Way Ne, W4657, Seattle, WA 98105-3901 | 2008-06-16 |
| 1164697066 | Russell Edgar Carlson IIi | Dentist | 1145 66th St, Suite 2, Windsor Heights, IA 50311-1705 | 2008-04-23 |
| 1679791438 | Russell J Carlson | Counselor | 2600 Oakland Ave, Elkhart, IN 46517-1533 | 2007-04-24 |
| Street Address |
2695 HARLEM RD |
| City | CHEEKTOWAGA |
| State | NY |
| Zip Code | 14225-4021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104856426 | Tasneem J. Shah, M.d., P.C. | Anesthesiology | 2695 Harlem Rd, Cheektowaga, NY 14225-4021 | 2006-07-03 |
| 1437451150 | Shah Medical Group PC | Obstetrics & Gynecology | 2695 Harlem Rd, Cheektowaga, NY 14225-4021 | 2010-12-01 |
| 1699871582 | Western New York Cardiothoracic | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2695 Harlem Rd, Cheektowaga, NY 14225-4021 | 2006-09-16 |
| 1073628244 | Mark Robert Jajkowski | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2695 Harlem Rd, Cheektowaga, NY 14225-4021 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124639885 | Jennifer Marki | Specialist/Technologist | 4226 Genesee St, Suite 400, Cheektowaga, NY 14225 | 2020-08-14 |
| 1609498138 | Schulz, Adult Health Np, Pllc | Nurse Practitioner | 678 Cleveland Drive, Cheektowaga, NY 14225 | 2020-05-06 |
| 1790252914 | Jacob William Debell | Student in an Organized Health Care Education/Training Program | 3469 Harlem Road, Cheektowaga, NY 14225 | 2018-10-25 |
| 1114441284 | Michael P Gugliuzza | Emergency Medical Technician, Paramedic | 239 Westbook Dr, Cheektowaga, NY 14225 | 2017-08-01 |
| 1841720307 | Buffalo Dental Implant | Dentist | 1526 Walden Ave. Suite 600, Buffalo Dental Implant, Cheektowaga, NY 14225 | 2017-06-18 |
| 1396279741 | Jacob Habermehl | Specialist/Technologist | 67 Lynncrest Terrace, Cheektowaga, NEW YORK 14225 | 2017-04-12 |
| 1588196901 | Cha Vu | Dentist | 2521 Walden Ave, Buffalo, NY 14225 | 2017-04-03 |
| 1881040244 | Amanda Sanders | Licensed Practical Nurse | 21 Kingswood Dr, Cheektowaga, NY 14225 | 2016-05-04 |
| 1255748638 | Valerie Knowles | Licensed Practical Nurse | 3527 Harlem Road, Cheektowaga, NY 14225 | 2014-07-17 |
| 1043569585 | Mark Timothy Morreale | Optometrist | 2000 Walden Avenue, Cheektowaga, NY 14225 | 2012-08-30 |
| Find all providers in zip 14225 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003509 | Gs Medical, P.C. | Surgery | 377-b Pearsall Ave, Cedarhurst, NY 11516 | 2020-11-02 |
| 1073128971 | New York Vascular Group, Pllc | Surgery | 19 Laurel Ave Ste 102, Cornwall, NY 12518-1403 | 2020-09-09 |
| 1578190179 | Camilo Jose Martinez | Surgery | 23 S Howell Ave Ste H, Centereach, NY 11720-4445 | 2020-03-24 |
| 1407483399 | Interventional Medicine | Surgery | 1122a Coney Island Ave, Brooklyn, NY 11230-2307 | 2020-03-23 |
| 1487287975 | Syracuse Professional Medical Services of New York LLC | Surgery | 1101 Erie Blvd E Ste 201a, Syracuse, NY 13210-1144 | 2020-02-13 |
| 1457983181 | Syracuse Medical of New York LLC | Surgery | 1101 Erie Blvd E Ste 201b, Syracuse, NY 13210-1144 | 2020-02-11 |
| 1366914483 | Star Veins Centers PC | Surgery | 225 W 35th St Frnt 2, New York, NY 10001-1904 | 2018-12-31 |
| 1528547312 | Norwood Professional Medical Services of New York LLC | Surgery | 3487-89 Jerome Ave, Ste A, Bronx, NY 10468 | 2018-08-13 |
| 1336628130 | Norwood Medical of New York LLC | Surgery | 3487-89 Jerome Ave, Ste B, Bronx, NY 10468 | 2018-08-13 |
| 1003393299 | Bushwick Professional Medical Services of New York LLC | Surgery | 441 Knickerbocker Ave Ste A, Brooklyn, NY 11237-4508 | 2018-07-20 |
| Find all providers with the same taxonomy | ||||
| City | CHEEKTOWAGA |
| Zip Code | 14225 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.