MICHAEL DAVID RUSSELL MD, MBA, MPH - NPI 1710484472 - Orthopaedic Surgery in Santa Monica, CA

Q: What is Michael Russell's NPI number?

The NPI number for Michael Russell is 1710484472. It was assigned to this individual provider in the NPPES registry on April 10, 2018.

Q: What is Michael Russell's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Pediatric Orthopaedic Surgery, with taxonomy code 207XP3100X.

Q: When was this NPI record last updated?

The NPPES record for Michael Russell was last updated on June 4, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Michael David Russell Md, Mba, Mph NPPES

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

MICHAEL DAVID RUSSELL MD, MBA, MPH (NPI 1710484472) is an individual pediatric orthopaedic surgery provider in Santa Monica, California, licensed in Texas (W6372) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1710484472

Entity TypeIndividualMale

Primary Taxonomy207XP3100X

Provider Legal NameMICHAEL DAVID RUSSELLCredential: MD, MBA, MPH

Location Address1131 WILSHIRE BLVD STE 100Santa Monica, CA 90401-2072

Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631

Phone(310) 319-3475

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateApril 10, 2018

Last NPPES UpdateJune 4, 20263 updates tracked since enumeration

NPPES CertifiedJune 4, 2026

✔ NPI 1710484472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Pediatric Orthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207XP3100X

License✔ Licensed in TX · W6372

Definition

An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones.

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License A185250 (CA)

1131 WILSHIRE BLVD STE 100, Santa Monica, CA 90401

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Secondary Practice Locations 3

Location 14102 24th St Ste 506Lubbock, TX 79410-1805 · Phone (806) 725-7980 · Fax (806) 723-7985

Location 21250 16th St Ste 2100Santa Monica, CA 90404-1249 · Phone (310) 319-1234

Location 31225 15th St Ste 2100Santa Monica, CA 90404-1101 · Phone (310) 319-1234

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael David Russell Md, Mba, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9032465885

PECOS Enrollment IDI20260605000642

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

13 services13 patients

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.

85.18/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

85.96

Promoting Interoperability

100

Improvement Activities

Cost

57.6

Other Providers at the Same Location NPPES 9

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

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