FAVEN GHEBREHIWET RUSSOM MD
NPI 1700588696
Student in an Organized Health Care Education/Training Program in Boston, MA

Q: What is Faven Russom's NPI number?

The NPI number for Faven Russom is 1700588696. It was assigned to this individual provider in the NPPES registry on March 21, 2023.

Q: What is Faven Russom's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Faven Russom was last updated on March 23, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 21, 2023PECOS Enrolled

801 ALBANY ST, BOSTON, MA 02119(617) 355-8241 Get Directions Write a Review

NPPES record last updated: March 23, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Faven Ghebrehiwet Russom Md NPPES

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

FAVEN GHEBREHIWET RUSSOM MD (NPI 1700588696) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700588696

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameFAVEN GHEBREHIWET RUSSOMCredential: MD

Location Address801 ALBANY STBoston, MA 02119-2560

Mailing Address801 Albany StBoston, MA 02119-2560 · (617) 355-8241

Phone(617) 355-8241

Sole ProprietorNo

Enumeration DateMarch 21, 2023

Last NPPES UpdateMarch 23, 2023

NPPES CertifiedMarch 23, 2023

✔ NPI 1700588696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

801 ALBANY ST, Boston, MA 02119

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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)

Faven Ghebrehiwet Russom 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.

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