MARK B RUSSI (MD) – Occupational Medicine Physician, NPI 1285615591

MARK B RUSSI (MD) is a healthcare provider. based in New haven, Connecticut. specializing in PREVENTIVE MEDICINE. They hold the professional credentials MD. They hold a License No. 032596 (CT). The NPI Number for MARK B RUSSI (MD) is 1285615591

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
MARK B RUSSI (MD)
NPI
1285615591
Phone
(203) 785-4197
Address
135 COLLEGE ST
Enumeration Date
14 November 2005
Last Update Date
1 April 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2037857191
Graduation Year
1989 (37 years ago)
PAC ID
3577698968
Group Practice PAC ID
9436061736
Professional Enrollment ID
I20100324000704
Address ID
CT065102483NE135XXSTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

24 PREVENTIVE MEDICINE in CT

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Provider Addresses for MARK B RUSSI (MD)

  • 135, College Street, Downtown, New Haven, New Haven County, Connecticut, 06511, United States

    THIRD FLOOR

    NEW HAVEN, CT 065102483

    Phone: (203) 785-4197

    Fax: (203) 785-7391

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-03-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100324000704IPreventive MedicineCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06510)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436061736View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology)CT
H E M A T O L O G Y/ O N C O L O G YCT
Internal Medicine, NephrologySC
-CT
-NC
Internal MedicineCT
-CT
Cardiac SurgeryCT
-CT
-CT

Reviews

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Frequently asked questions

Where can patients find MARK B RUSSI (MD)'s NPI?
You can confirm MARK B RUSSI (MD) with NPI 1285615591; it appears in the national provider directory.
Is MARK B RUSSI (MD) active in the national directory?
MARK B RUSSI (MD)'s public NPI profile is in an active state.
What does MARK B RUSSI (MD) treat or focus on?
Patients typically see MARK B RUSSI (MD) under the specialty Occupational Medicine Physician. Clinical services aligned with this taxonomy classification.
Does MARK B RUSSI (MD) practice in Connecticut?
You will see New Haven, Connecticut on file for MARK B RUSSI (MD) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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