Active NPI 1568573947 Individual Practitioner Female Practitioner

Beverly Russell , PA

Physician Assistant • Jackson, MI

Professional Overview & Biography Verified Profile Summary

Beverly Russell, PA is a registered healthcare professional specializing in Physician Assistant in Jackson, MI. Practice services are available at 1111 TENEYCK ST under active NPI credentials.

Frequently performed procedures and clinical services include removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing, established patient outpatient office visit, new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1111 Teneyck St

Jackson, MI 492012461

Telephone 5172058940

Fax 5172050108

Associated Practice Facility / Clinic

🏢 Ent Associates Of Jackson, P.c. Facility NPI 1922109438

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Jackson, MI

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 11.8 Yrs

State Avg: 12.2 Yrs

Regional Practice Density

104 Specialists

Practicing in Jackson, MI (7057 Statewide)

Telehealth Adoption Rate

3.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

42.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0268 Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing	98	77	$75.00	$27.27
99213 Established patient office or other outpatient visit, typically 15 minutes	86	65	$77.44	$52.64
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$100.64	$65.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
69210 Removal of impacted ear wax	114	93	$123.03	$27.07
99213 Established patient office or other outpatient visit, typically 15 minutes	102	78	$73.65	$54.00
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	28	28	$88.00	$68.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
69210 Removal of impacted ear wax	168	125	$112.05	$27.71
99213 Established patient office or other outpatient visit, typically 15 minutes	107	84	$76.00	$55.89
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	38	38	$93.63	$69.38
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$39.00	$30.38

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
69210 Removal of impacted ear wax	113	90	$130.75	$27.98
99213 Established patient office or other outpatient visit, typically 15 minutes	82	72	$76.22	$56.10
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	28	28	$88.00	$70.64
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	19	18	$39.00	$30.37
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	18	$110.94	$84.09
92504 Exam of ear using a microscope	16	13	$30.00	$7.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
69210 Removal of impacted ear wax	108	90	$122.22	$28.64
99213 Established patient office or other outpatient visit, typically 15 minutes	89	79	$63.73	$43.65
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$143.00	$110.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	19	13	$110.00	$61.14
99202 New patient office or other outpatient visit, typically 20 minutes	15	15	$110.00	$62.89
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	11	$62.00	$35.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$160.00	$89.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	14	13	$110.00	$58.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	20	19	$110.00	$59.45
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$160.00	$88.06
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$110.00	$60.78

Medical Specialties & State Licenses

CMS Verified: 2020-12-28

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MI 5601004024

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

1568573947 (MI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners

Anissa Peterson , PA-C

Physician Assistant

NPI 1093434870

Physician Assistant (Certified)

Dr. Tate Naylor , MD

Otolaryngology

NPI 1144718701

Doctor of Medicine (M.D.)

Dr. Syed Ali , MD

Otolaryngology

NPI 1164800546

Doctor of Medicine (M.D.)

Dr. Emily Buitron Courter , AuD

Audiologist

NPI 1174217418

Doctor of Audiology

Kristen Patel , PA-C

Physician Assistant

NPI 1386262574

Physician Assistant (Certified)

Dr. Jonathon Vargo , MD

Otolaryngology

NPI 1811438245

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location January 04, 2021

Registered at 1111 TENEYCK ST, JACKSON, MI 492012461 (Tel: 5172058940)

📍

Updated Business Mailing Address January 04, 2021

Registered at 1111 TENEYCK ST, JACKSON, MI 492012461 (Tel: 5172058940)

✅

NPI Profile Active October 15, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location October 15, 2014

Registered at 601 JOHN ST, BOX 74, KALAMAZOO, MI 490075341 (Tel: 2693418481)

📍

Updated Business Mailing Address October 15, 2014

Registered at 601 JOHN ST, BOX 74, KALAMAZOO, MI 490075341 (Tel: 2693418481)

👤

Provider Name / Credentials Updated October 15, 2014

Recorded as BEVERLY RUSSELL, PA

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 15, 2014

Physician Assistant (License #5601004024 in MI)

🟢

Initial NPI Registration & Enumeration August 31, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1568573947

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 31, 2006

Last Update: January 04, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1111 Teneyck St

Jackson, MI 492012461

Phone: 5172058940

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.