SHANNAN R RUSS N.P.
NPI 1457405144
Nurse Practitioner - Family in Elmira, NY

Active since January 22, 2007PECOS EnrolledAccepts Medicare Assignment
1005 WALNUT ST, ELMIRA, NY 14901(607) 734-3968(833) 450-5884 Get Directions Write a Review

NPPES record last updated: March 20, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Shannan R Russ N.p. NPPES

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

SHANNAN R RUSS N.P. (NPI 1457405144) is an individual family provider in Elmira, New York, licensed in New York (F332653) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of Saginaw Valley Medical College - Nlg (1999).

NPPES Registry Identity

NPI1457405144
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANNAN R RUSSCredential: N.P.
Location Address1005 WALNUT STElmira, NY 14901-1007
Mailing Address1005 Walnut StElmira, NY 14901-1007 · (607) 734-3968 · Fax (833) 450-5884
Fax(833) 450-5884
Sole ProprietorNo
Medical School CMSSaginaw Valley Medical College - NlgGraduated 1999
Enumeration DateJanuary 22, 2007
Last NPPES UpdateMarch 20, 2025
NPPES CertifiedMarch 20, 2025
NPI 1457405144 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in NY · F332653
1005 WALNUT ST, Elmira, NY 14901

Other Names 1

Former Name (1)Shannan R Hamilton N.p.

Other Identifiers 1

Medicaid02001921NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Shannan R Russ N.p. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264412683
PECOS Enrollment IDI20040724000211
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 14901 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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 8

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

Midwife
1005 WALNUT ST
ELMIRA, NY 14901
Specialist
1005 WALNUT ST
ELMIRA, NY 14901
Midwife
1005 WALNUT ST
ELMIRA, NY 14901
Advanced Practice Midwife
1005 WALNUT ST
ELMIRA, NY 14901
Family Medicine
1005 WALNUT ST
ELMIRA, NY 14901
Obstetrics & Gynecology
1005 WALNUT ST
ELMIRA, NY 14901
Obstetrics & Gynecology (Gynecology)
1005 WALNUT ST
ELMIRA, NY 14901
Advanced Practice Midwife
1005 WALNUT ST
ELMIRA, NY 14901

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1457405144, enumerated as an "individual" on January 22, 2007.

The provider is located at 1005 WALNUT ST ELMIRA, NY 14901 and the phone number is (607) 734-3968.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.