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JESSICA HOLLY RUSSELL CNM
NPI 1891440640
Obstetrics & Gynecology in Stony Brook, NY

Active since February 18, 2022PECOS Enrolled
98.52/100
CMS Quality Rating
101 NICOLLS RD, STONY BROOK, NY 11794(631) 444-4000 Get Directions Write a Review

NPPES record last updated: May 3, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 3, 2022, Feb 18, 2022 (2 updates tracked since 2022).

About Jessica Holly Russell Cnm NPPES

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

JESSICA HOLLY RUSSELL CNM (NPI 1891440640) is an individual obstetrics & gynecology provider in Stony Brook, New York, licensed in New York (F002033-01) and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891440640
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameJESSICA HOLLY RUSSELLCredential: CNM
Location Address101 NICOLLS RDStony Brook, NY 11794-0001
Mailing Address2479 Riverside DrWantagh, NY 11793-4543 · (631) 252-4046
Phone(631) 444-4000
Sole ProprietorYes
Enumeration DateFebruary 18, 2022
Last NPPES UpdateMay 3, 20222 updates tracked since enumeration
NPPES CertifiedMay 3, 2022
✔ NPI 1891440640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in NY · F002033-01
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
101 NICOLLS RD, Stony Brook, NY 11794
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Holly Russell Cnm 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11794 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
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
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.

98.52/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.85
Promoting Interoperability100
Improvement Activities40

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.

NARINDER SINGH M.D.
Internal Medicine
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 444-4000
DR. KANHAI FARRAKHAN MD
Internal Medicine (Gastroenterology)
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 444-0580
MS. HAYLEY ALEXANDRA MENA LMSW
Social Worker (Clinical)
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (516) 761-4107
MRS. HEATHER MARIE CALIGIURI ANP
Nurse Practitioner (Adult Health)
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 631-4449
MR. SAM TARIK MENDOUNE I NP
Nurse Practitioner (Adult Health)
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 335-1657
ALEXIE LESSING
Student in an Organized Health Care Education/Training Program
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 444-4686
DR. BENJAMIN RISMANY MD
Student in an Organized Health Care Education/Training Program
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 444-1791
JULIA RYAN MD
Student in an Organized Health Care Education/Training Program
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 689-8333

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 Jessica Russell's NPI number?

The NPI number for Jessica Russell is 1891440640. It was assigned to this individual provider in the NPPES registry on February 18, 2022.

Where is Jessica Russell located?

Jessica Russell practices at 101 Nicolls Rd, Stony Brook, NY 11794. The listed phone number is (631) 444-4000.

What is Jessica Russell's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Jessica Russell enrolled in Medicare?

Yes. Jessica Russell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jessica Russell was last updated on May 3, 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.