ROBERT CARSON RUSSELL DO
NPI 1710620927
Emergency Medicine in Peoria, IL

Q: What is Robert Russell's NPI number?

The NPI number for Robert Russell is 1710620927. It was assigned to this individual provider in the NPPES registry on April 15, 2022.

Q: What is Robert Russell's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Robert Russell was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.

Active since April 15, 2022PECOS Enrolled

530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2109 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 1, 2025, Apr 15, 2022 (2 updates tracked since 2022).

On this page

About Robert Carson Russell Do NPPES

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

ROBERT CARSON RUSSELL DO (NPI 1710620927) is an individual emergency medicine provider in Peoria, Illinois, licensed in Illinois (036173028) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710620927

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameROBERT CARSON RUSSELLCredential: DO

Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001

Mailing Address530 Ne Glen Oak AvePeoria, IL 61637-0001 · (309) 655-2109

Phone(309) 655-2109

Sole ProprietorNo

Enumeration DateApril 15, 2022

Last NPPES UpdateJuly 1, 20252 updates tracked since enumeration

NPPES CertifiedJuly 1, 2025

✔ NPI 1710620927 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in IL · 036173028

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

530 NE GLEN OAK AVE, Peoria, IL 61637

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Robert Carson Russell Do 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.

Medicare Billing Reassignment

Medicare enrollment records show Robert Russell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Utah Valley Emergency Physicians Inc

1,161 mi

Emergency Medicine

1034 NORTH 500 WEST, ER DEPARTMENT
Provo, UT 84604

Reassigned Medicare billing, Utah enrollment
59 clinicians in this Medicare group

NPI 1649204553 (877) 346-2211

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61637 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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 20

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

DR. HAMID MAHMOOD ZIA M.D

Pathology (Anatomic Pathology & Clinical Pathology)

530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637

Peoria County (309) 624-9011

THOMAS JAMES MCMORROW MD

Pediatrics