RUSSELL WILLIAM WHITE (PA-C) – Physician Assistant, NPI 1174022206

RUSSELL WILLIAM WHITE (PA-C) is a healthcare provider. based in Bradenton, Florida. specializing in Physician Assistant. They hold the professional credentials PA-C. They hold a License No. 1141269 (FL). The NPI Number for RUSSELL WILLIAM WHITE (PA-C) is 1174022206

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
RUSSELL WILLIAM WHITE (PA-C)
NPI
1174022206
Phone
(941) 782-0200
Address
6015 POINTE WEST BLVD
Enumeration Date
5 February 2018
Last Update Date
12 February 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9417921404
Graduation Year
2017 (9 years ago)
PAC ID
2668734963
Group Practice PAC ID
3274504386
Professional Enrollment ID
I20180327000507
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

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Provider Addresses for RUSSELL WILLIAM WHITE (PA-C)

  • 6015, Pointe West Boulevard, Bradenton, Manatee County, Florida, 34209, United States

    BRADENTON, FL 342095525

    Phone: (941) 782-0200

    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)

CMS reports 3 Open Payments records for all available years, with a total value of $102.

Total Amount is formed as General ($102) + Research ($0) + Ownership ($0) = $102.

Last reported payment date: 2023-12-15 • Largest payer in this snapshot: Smith+Nephew, Inc. ($102).

Total Amount

$102

General + Research + Ownership

Payments

3

Total payment records

General Amount

$102

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-12-15

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Smith+Nephew, Inc.$102
View all Open Payments →|Open Payments Risk Radar →

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: 2018-03-27

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
I20180327000507IPhysician AssistantFLTBD

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 34209)

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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: 3274504386View full group profile
NameSpecialtyState
Physician AssistantOH
Physician AssistantFL
-FL
Orthopedic SurgeryFL
Physical Therapist In Private PracticeFL
Physician AssistantFL
Physician AssistantFL
Orthopedic SurgeryFL
Nurse PractitionerFL
Physical Therapist In Private PracticeFL

Reviews

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Frequently asked questions

Does RUSSELL WILLIAM WHITE (PA-C) have a public NPI I can cite?
Public records show RUSSELL WILLIAM WHITE (PA-C) under NPI 1174022206.
Quick check: is RUSSELL WILLIAM WHITE (PA-C) active?
Public NPPES data shows RUSSELL WILLIAM WHITE (PA-C) with an active NPI status right now.
What services align with RUSSELL WILLIAM WHITE (PA-C)'s listing?
RUSSELL WILLIAM WHITE (PA-C)'s public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
Is RUSSELL WILLIAM WHITE (PA-C) tied to Bradenton, Florida?
If you are local to Bradenton, Florida, RUSSELL WILLIAM WHITE (PA-C) may be relevant to your search.
Can I export RUSSELL WILLIAM WHITE (PA-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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