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DR. SAMUEL PETER RUSSELL MD
NPI 1215564265
Pediatrics in San Diego, CA

Active since March 26, 2020PECOS Enrolled
3020 CHILDRENS WAY, SAN DIEGO, CA 92123(858) 966-8800 Get Directions Write a Review

NPPES record last updated: May 10, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 10, 2023, Aug 4, 2021, Mar 26, 2020 (3 updates tracked since 2020).

About Dr. Samuel Peter Russell Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SAMUEL PETER RUSSELL MD (NPI 1215564265) is an individual pediatrics provider in San Diego, California, licensed in California (A186031) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215564265
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. SAMUEL PETER RUSSELLCredential: MD
Location Address3020 CHILDRENS WAYSan Diego, CA 92123-4223
Mailing Address3020 Childrens Way # Mc5003San Diego, CA 92123-4223 · (858) 309-6300
Phone(858) 966-8800
Sole ProprietorNo
Enumeration DateMarch 26, 2020
Last NPPES UpdateMay 10, 20233 updates tracked since enumeration
NPPES CertifiedMay 10, 2023
✔ NPI 1215564265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A186031
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3020 CHILDRENS WAY, San Diego, CA 92123
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samuel Peter Russell Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92123 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NATALIE E. ELLINGTON MD
Pathology (Pediatric Pathology)
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-5944
SHANNA MICHAEL MILLER-NABAS RDN
Physician Assistant
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 576-1700
DR. ADRIANA HERRERA TREMOULET M.D.
Pediatrics (Pediatric Infectious Diseases)
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-7785
LORI MCCURDY M.S., CCC-SLP
Speech-Language Pathologist
3020 CHILDRENS WAY, MC5010
SAN DIEGO, CA 92123
San Diego County (858) 968-5838
MS. ANN M SUMIDA-JOHNSON M.A..
Audiologist
3020 CHILDRENS WAY, MC 5010
SAN DIEGO, CA 92123
San Diego County (858) 966-5838
RICHARD JOHN NEWTON M.D.
Pediatrics
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-8036
DR. SHAHFAR KHAN M.D.
Pediatrics (Pediatric Emergency Medicine)
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-8800
CARLY BETH WELCH CPNP-AC
Nurse Practitioner (Pediatrics)
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-8800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Russell's NPI number?

The NPI number for Samuel Russell is 1215564265. It was assigned to this individual provider in the NPPES registry on March 26, 2020.

Where is Samuel Russell located?

Samuel Russell practices at 3020 Childrens Way, San Diego, CA 92123. The listed phone number is (858) 966-8800.

What is Samuel Russell's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Samuel Russell enrolled in Medicare?

Yes. Samuel Russell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samuel Russell was last updated on May 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.