JACQUELINE M RUSSELL (DO) – Family Medicine Physician, NPI 1730742107
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,710 FAMILY PRACTICE in NY
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Provider Addresses for JACQUELINE M RUSSELL (DO)
334 MAIN ST APT 4
SACO, ME 040721503
Phone: (941) 350-4110
Type: Mailing
Saint Barnabas Hospital, 4487, 3rd Avenue, The Bronx, Bronx County, New York, 10457, United States
BRONX, NY 104571526
Phone: (718) 960-9000
Type: Location
210 HOLMES RD
SCARBOROUGH, ME 040748410
Phone: (207) 995-0732
Type: Mailing
37 PALMER ST STE 3
CALAIS, ME 046191341
Phone: (207) 454-8195
Type: Location
156 CHESTNUT ST
MANCHESTER, CT 060405933
Phone: (941) 350-4110
Type: Mailing
130 HARTFORD RD
MANCHESTER, CT 060405921
Phone: (860) 533-4678
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $435.
Total Amount is formed as General ($435) + Research ($0) + Ownership ($0) = $435.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($108).
Total Amount
$435
General + Research + Ownership
Payments
23
Total payment records
General Amount
$435
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2023-07-10
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230710003702 | I | Family Practice | ME | TBD |
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.
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 04072)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | ME | |
| - | ME | |
| - | NM | |
| - | ME | |
| Nurse Practitioner | ME | |
| - | ME | |
| Nurse Practitioner | ME | |
| P O D I A T R Y | ME | |
| - | ME | |
| - | ME |
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