MS. SHELLY RAE RUSSEFF (APRN-CNP) – Family Nurse Practitioner, NPI 1053710053
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,299 NURSE PRACTITIONER in OK
Provider Addresses for MS. SHELLY RAE RUSSEFF (APRN-CNP)
105 N INDIAN MERIDIAN RD
PAULS VALLEY, OK 730759236
Phone: (405) 207-9800
Fax: (405) 207-9898
Type: Location
106 N POWELL
WYNNEWOOD, OK 73098
Phone: (405) 665-1010
Fax: (405) 665-1001
Type: Location
301 E SEMINOLE ST APT 2
WYNNEWOOD, OK 730985629
Phone: (405) 207-1116
Fax: (405) 665-1001
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $427.
Total Amount is formed as General ($427) + Research ($0) + Ownership ($0) = $427.
Last reported payment date: 2024-10-28 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($268).
Total Amount
$427
General + Research + Ownership
Payments
12
Total payment records
General Amount
$427
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-28
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: 2015-10-19
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 |
|---|---|---|---|---|
| I20151019000323 | I | Nurse Practitioner | OK | 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 73075)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OK | |
| Internal Medicine, Pediatric Medicine | OK | |
| U R O L O G Y | OK | |
| Clinical Social Worker | OK | |
| Physician Assistant | OK | |
| Family Practice | OK | |
| Physician Assistant | OK | |
| Orthopedic Surgery | OK | |
| Family Practice | OK | |
| Family Practice | OK |
Reviews
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