Russell Stackhouse MD PA
NPI 1538655014ActiveOrganization· Ophthalmology· Fernandina, FL
Ophthalmology in Fernandina, Florida, registered in NPPES in July 2018. The authorized official on file is Nichole Rene Barnett, Practice Administrator. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1538655014 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 8, 2018 |
| Last updated in NPPES | Dec 13, 2022 |
| Certified by provider | Dec 13, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Ophthalmology Primary | 207W00000X | ME117902 | FL |
| Orthopaedic Surgery, Foot and Ankle Surgery | 207XX0004X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (GA) |
|---|
Other Ophthalmology providers in Fernandina
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