Physician Compare National (NPI:1467413815)

HEALTHCARE PROVIDER: KARREN RUSSO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1467413815
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6800799677
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040129000332
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LAIRD RUSSO
	Individual professional last name
Provider First Name	KARREN
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ALEXANDRIA EYE AND LASER CENTER LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4789641010
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	17
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1055 PKWY DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	NATCHITOCHES
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	714576276
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3183520444
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	190298
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CENTRAL LOUISIANA SURGICAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	190026
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	RAPIDES REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	190007
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	NATCHITOCHES REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y