MARC PHILLIP RUSSELL M.D.
NPI 1861431066
Hospitalist in Lexington, KY

Active since June 05, 2006PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
1740 NICHOLASVILLE RD, LEXINGTON, KY 40503(859) 260-6348(859) 260-4350 Get Directions Write a Review

NPPES record last updated: March 8, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Marc Phillip Russell M.d. NPPES

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

MARC PHILLIP RUSSELL M.D. (NPI 1861431066) is an individual hospitalist provider in Lexington, Kentucky, licensed in Kentucky (40067) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Lexington, and is a graduate of University Of Kentucky College Of Medicine (2003).

NPPES Registry Identity

NPI1861431066
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameMARC PHILLIP RUSSELLCredential: M.D.
Location Address1740 NICHOLASVILLE RDLexington, KY 40503-1431
Mailing AddressPo Box 910670Lexington, KY 40591-0670 · (859) 260-4385 · Fax (859) 260-4386
Fax(859) 260-4350
Sole ProprietorNo
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 2003
Enumeration DateJune 5, 2006
Last NPPES UpdateMarch 8, 2010
NPI 1861431066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License Licensed in KY · 40067
Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

1740 NICHOLASVILLE RD, Lexington, KY 40503

Accepted 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

Marc Phillip Russell M.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 ID9436247244
PECOS Enrollment IDI20071113000027
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 8

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.

Follow-up hospital inpatient care per day, typically 25 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
329 services184 patients
Follow-up hospital inpatient care per day, typically 35 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
312 services211 patients
Follow-up hospital inpatient care per day, typically 15 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
98 services65 patients
Initial hospital inpatient care per day, typically 70 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
85 services85 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
63 services62 patients
Hospital observation care on day of discharge 99217
Hospital observation care on the day of discharge involves monitoring your health status to ensure stability before you leave. This includes assessing vital signs, response to treatment, and readiness for home care or rehabilitation.
15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Health Lexington

Acute Care Hospitals · Lexington, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number180103
Location1740 Nicholasville RoadLexington, KY 40503 · Fayette County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40503 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality89.59
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers14 claims14 services$15.38 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers14 claims14 services$76.38 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Anesthesiology
1740 NICHOLASVILLE RD
LEXINGTON, KY 40503
Emergency Medicine (Emergency Medical Services)
1740 NICHOLASVILLE RD, CENTRAL BAPTIST HOSPITAL EMERGENCY ROOM
LEXINGTON, KY 40503
Emergency Medicine (Emergency Medical Services)
1740 NICHOLASVILLE RD, CENTRAL BAPTIST HOSPITAL EMERGENCY ROOM
LEXINGTON, KY 40503
Emergency Medicine (Emergency Medical Services)
1740 NICHOLASVILLE RD, CENTRAL BAPTIST HOSPITAL EMERGENCY ROOM
LEXINGTON, KY 40503
Nurse Anesthetist, Certified Registered
1740 NICHOLASVILLE RD
LEXINGTON, KY 40503
Nurse Practitioner
1740 NICHOLASVILLE RD
LEXINGTON, KY 40503
Physical Therapist
1740 NICHOLASVILLE RD
LEXINGTON, KY 40503
Registered Nurse (Registered Nurse First Assistant)
1740 NICHOLASVILLE RD
LEXINGTON, KY 40503

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 Marc Russell's NPI number?

The NPI number for Marc Russell is 1861431066. It was assigned to this individual provider in the NPPES registry on June 5, 2006.

Where is Marc Russell located?

Marc Russell practices at 1740 Nicholasville Rd, Lexington, KY 40503. The listed phone number is (859) 260-6348.

What is Marc Russell's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Marc Russell enrolled in Medicare?

Yes. Marc Russell 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 Marc Russell accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Marc Russell 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.

Is Marc Russell affiliated with any hospitals?

According to CMS data, Marc Russell is affiliated with Baptist Health Lexington.

When was this NPI record last updated?

The NPPES record for Marc Russell was last updated on March 8, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.