1. Home
  2. Directory
  3. North Carolina
  4. Raleigh
  5. Otolaryngology
  6. NPI Profile

DR. RUSSELL GLEN MEDDERS MD
NPI 1376501049
Otolaryngology in Raleigh, NC

Active since May 03, 2006PECOS Enrolled
82.48/100
CMS Quality Rating
4600 LAKE BOONE TRAIL, SUITE 100, RALEIGH, NC 27607(919) 787-1374(919) 571-8135 Get Directions Write a Review

NPPES record last updated: July 9, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Russell Glen Medders Md NPPES

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

DR. RUSSELL GLEN MEDDERS MD (NPI 1376501049) is an individual otolaryngology provider in Raleigh, North Carolina, licensed in North Carolina (29710) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376501049
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. RUSSELL GLEN MEDDERSCredential: MD
Location Address4600 LAKE BOONE TRAIL, SUITE 100Raleigh, NC 27607-7529
Mailing Address4600 Lake Boone Trail, Suite 100Raleigh, NC 27607-7529 · (919) 787-1374 · Fax (919) 571-8135
Phone(919) 787-1374
Fax(919) 571-8135
Sole ProprietorNo
Enumeration DateMay 3, 2006
Last NPPES UpdateJuly 9, 2021
NPPES CertifiedJuly 9, 2021
✔ NPI 1376501049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in NC · 29710
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
4600 LAKE BOONE TRAIL, Raleigh, NC 27607
Open in Google Maps ↗

Other Identifiers 4

Medicaid8958402NC
Other1050117NC · United Healthcare
Other58402NC · Blue Cross
Other040002669NC · Railroad Medicare

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. Russell Glen Medders 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 27607 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

82.48/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality67.75
Promoting Interoperability97
Improvement Activities40
Cost76.36

Other Providers at the Same Location NPPES 7

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

MELANIE CORGILL-COX CCC-A-SLP
Audiologist-Hearing Aid Fitter
4600 LAKE BOONE TRAIL, SUITE 100
RALEIGH, NC 27607
Wake County (919) 787-1374
DR. STANLEY A WILKINS MD
Otolaryngology
4600 LAKE BOONE TRAIL, SUITE 100
RALEIGH, NC 27607
Wake County (919) 787-1374
DR. DAVID A CLARK MD
Otolaryngology
4600 LAKE BOONE TRAIL, SUITE 100
RALEIGH, NC 27607
Wake County (919) 787-1374
DR. STEVEN H DENNIS MD
Otolaryngology
4600 LAKE BOONE TRAIL, SUITE 100
RALEIGH, NC 27607
Wake County (919) 787-1374
CAPITOL EAR, NOSE & THROAT
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
4600 LAKE BOONE TRAIL, SUITE 100
RALEIGH, NC 27607
Wake County (919) 787-1374
MARK S BROWN MD
Otolaryngology
4600 LAKE BOONE TRAIL, SUITE 100
RALEIGH, NC 27607
Wake County (919) 787-1374
EMILY CATHERINE BURT AU.D
Audiologist-Hearing Aid Fitter
4600 LAKE BOONE TRAIL, SUITE 100
RALEIGH, NC 27607
Wake County (919) 787-1374

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 Russell Medders's NPI number?

The NPI number for Russell Medders is 1376501049. It was assigned to this individual provider in the NPPES registry on May 3, 2006.

Where is Russell Medders located?

Russell Medders practices at 4600 Lake Boone Trail Suite 100, Raleigh, NC 27607. The listed phone number is (919) 787-1374.

What is Russell Medders's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Russell Medders enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Russell Medders was last updated on July 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.