DR. RUSSELL KEITH BOMSE PH.D.
NPI 1780725705
Psychologist - Clinical in Northport, NY

Q: What is Russell Bomse's NPI number?

The NPI number for Russell Bomse is 1780725705. It was assigned to this individual provider in the NPPES registry on February 11, 2007.

Q: What is Russell Bomse's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Russell Bomse was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 February 11, 2007PECOS EnrolledAccepts Medicare Assignment

90 MAR KAN DR, NORTHPORT, NY 11768(631) 754-6192 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Russell Keith Bomse Ph.d. NPPES

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

DR. RUSSELL KEITH BOMSE PH.D. (NPI 1780725705) is an individual clinical provider in Northport, New York, licensed in New York (009117-1) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1985).

NPPES Registry Identity

NPI1780725705

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. RUSSELL KEITH BOMSECredential: PH.D.

Location Address90 MAR KAN DRNorthport, NY 11768-1858

Mailing Address90 Mar Kan DrNorthport, NY 11768-1858 · (631) 754-6192

Phone(631) 754-6192

Sole ProprietorYes

Medical School CMSOtherGraduated 1985

Enumeration DateFebruary 11, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1780725705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NY · 009117-1

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

90 MAR KAN DR, Northport, NY 11768

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

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

Dr. Russell Keith Bomse Ph.d. 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 ID547284523

PECOS Enrollment IDI20060117000924

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 11768 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

$203.53 typical visit price

range $67.40 – $203.53

Typical copayment $50.88 (range $16.85 – $50.88)

Most-billed visit code 99205

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Russell Bomse's NPI number?

The NPI number for Russell Bomse is 1780725705. It was assigned to this individual provider in the NPPES registry on February 11, 2007.

Where is Russell Bomse located?

Russell Bomse practices at 90 Mar Kan Dr, Northport, NY 11768. The listed phone number is (631) 754-6192.

What is Russell Bomse's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Russell Bomse enrolled in Medicare?

Yes. Russell Bomse is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Russell Bomse accept?

Health plans from Providence Health Plan list Russell Bomse as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Russell Bomse was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.