DR. RUSSELL BRIAN FRIDSON DO
NPI 1770013559
Psychiatry & Neurology - Child & Adolescent Psychiatry in Detroit, MI

Q: What is Russell Fridson's NPI number?

The NPI number for Russell Fridson is 1770013559. It was assigned to this individual provider in the NPPES registry on June 14, 2017.

Q: What is Russell Fridson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Russell Fridson was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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 June 14, 2017PECOS Enrolled

3901 BEAUBIEN ST, DETROIT, MI 48201(616) 456-0842 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Feb 19, 2019, Jun 14, 2017 (3 updates tracked since 2017).

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About Dr. Russell Brian Fridson Do NPPES

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

DR. RUSSELL BRIAN FRIDSON DO (NPI 1770013559) is an individual child & adolescent psychiatry provider in Detroit, Michigan, licensed in Michigan (5101026596) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770013559

Entity TypeIndividualMale

Primary Taxonomy2084P0804X

Provider Legal NameDR. RUSSELL BRIAN FRIDSONCredential: DO

Location Address3901 BEAUBIEN STDetroit, MI 48201-2196

Mailing Address3901 Beaubien StDetroit, MI 48201-2196

Phone(616) 456-0842

Sole ProprietorNo

Enumeration DateJune 14, 2017

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

NPPES CertifiedJune 29, 2022

✔ NPI 1770013559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

License✔ Licensed in MI · 5101026596

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 5101023239 (MI), 5151009728 (MI)

3901 BEAUBIEN ST, Detroit, MI 48201

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Russell Brian Fridson 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.

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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.

KAROLINA MAKSIMOWSKI

Pediatrics (Pediatric Emergency Medicine)