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

Q: What is Shannan Russ's NPI number?

The NPI number for Shannan Russ is 1457405144. It was assigned to this individual provider in the NPPES registry on January 22, 2007.

Q: What is Shannan Russ's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Shannan Russ was last updated on March 20, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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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

Phone(607) 734-3968

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

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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.

MRS. KARYN NICKERSON C.N.M.

Midwife