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KODY EUGENE RUSSELBURG
NPI 1902556822
Anesthesiology in Gainesville, FL

Active since March 24, 2022PECOS EnrolledAccepts Medicare Assignment
1600 SW ARCHER RD, GAINESVILLE, FL 32610(352) 265-8336(352) 273-8612 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kody Eugene Russelburg NPPES

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

KODY EUGENE RUSSELBURG (NPI 1902556822) is an individual anesthesiology provider in Gainesville, Florida, licensed in Florida (OS23935) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, is affiliated with Uf Health Shands Hospital, and maintains a secondary practice location in Ocala.

NPPES Registry Identity

NPI1902556822
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameKODY EUGENE RUSSELBURG
Location Address1600 SW ARCHER RDGainesville, FL 32610-3003
Mailing Address1431 Sw 1st AveOcala, FL 34471-6500
Phone(352) 265-8336
Fax(352) 273-8612
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMarch 24, 2022
Last NPPES UpdateJuly 10, 2026
NPPES CertifiedJuly 10, 2026
✔ NPI 1902556822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in FL · OS23935
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1600 SW ARCHER RD, Gainesville, FL 32610
Open in Google Maps ↗

Secondary Practice Location 1

Location 11431 SW 1st AveOcala, FL 34471-6500 · Phone (352) 401-8323

Other Identifiers 1

Medicaid131601400FL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kody Eugene Russelburg 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 ID4284106568
PECOS Enrollment IDI20260617003676
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 Kody Russelburg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Florida Clinical Practice Association Inc
Same address
Surgery
1600 SW ARCHER RD
Gainesville, FL 32610
  • Reassigned Medicare billing, Florida enrollment
  • 3,324 clinicians in this Medicare group
NPI 1063463768 (352) 265-7922

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

Hospital Affiliations CMS Care Compare

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

Uf Health Shands Hospital

Acute Care Hospitals · Gainesville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100113
Location1600 SW Archer RdGainesville, FL 32610 · Alachua County
Emergency services Birthing friendly

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. BAHAREH EBADIFAR KEITH DO
Pediatrics
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-0462
AFRASYAB KHAN
Surgery
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 265-0680
GULSUN ERDAG MD
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 265-9900
DR. ALBERT H. MATTIA D.D.S.
Dentist (Prosthodontics)
1600 SW ARCHER RD, D4-4
GAINESVILLE, FL 32610
Alachua County (352) 273-5801
JOANNA CHAFFIN
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 627-9272
DR. CASEY JUSTIN BEAL MD
Ophthalmology
1600 SW ARCHER RD, BOX 100284
GAINESVILLE, FL 32610
Alachua County (352) 273-8778
WILLIAM CRAIG HICKS CRNA
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-6438
HENRY FONTILLAS PATALINGHUG CRNA
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-6438

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 Kody Russelburg's NPI number?

The NPI number for Kody Russelburg is 1902556822. It was assigned to this individual provider in the NPPES registry on March 24, 2022.

Where is Kody Russelburg located?

Kody Russelburg practices at 1600 SW Archer Rd, Gainesville, FL 32610. The listed phone number is (352) 265-8336.

What is Kody Russelburg's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Kody Russelburg enrolled in Medicare?

Yes. Kody Russelburg 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.

Which organization bills Medicare for Kody Russelburg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kody Russelburg reassigns Medicare benefits to Florida Clinical Practice Association Inc (Gainesville, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kody Russelburg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Kody Russelburg affiliated with any hospitals?

According to CMS data, Kody Russelburg is affiliated with Uf Health Shands Hospital.

When was this NPI record last updated?

The NPPES record for Kody Russelburg was last updated on July 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.