Active NPI
Michael Paul Russo, MD
- Obstetrics & Gynecology Physician
- York, PA
National Provider Identifier
1003840505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD023752E
- Practice address
- 4222 Lincoln Hwy
York, PA 17406-8083 - Phone
- (717) 812-7800
- Fax
- (717) 812-7811
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD023752E | PA | Primary |
Addresses
Primary practice location
4222 Lincoln Hwy
York, PA 17406-8083
Mailing address
3421 Concord Rd
York, PA 17402-9001
Phone (717) 812-7800
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1142793 | Other | PA | AMERIHEALTH MERCY-WMG |
| 36693 | Other | PA | GEISINGER |
| 0068412000 | Other | PA | AMERIHEALTH 65 PA |
| 1517480 | Other | PA | GATEWAY-WMG |
| 000985796 | Medicaid | PA | |
| 086178 | Other | PA | HIGHMARK BLUE SHIELD |
| 348556 | Other | PA | MAMSI-WMG |
| 30115669 | Other | PA | AMERIHEALTH MERCY - WMG |
| 4545155 | Other | PA | AETNA |
| 30120490 | Other | PA | AMERIHEALTH MERCY - YH |
| 20072397 | Other | PA | AMERIHEALTH MERCY-YHOBGYN |
| 03124601 | Other | PA | CAPITAL BLUE CROSS-WMG |
| 032661 | Other | PA | JOHNS HOPKINS |
| 053883300 | Medicaid | MD | |
| 524955 | Other | MD | CAREFIRST MD BCBS |
| 81659 | Other | PA | UNISON-WMG |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Designer Family Eyecare, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Eyewear Supplier
- York, PA
- NPI 1487796421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500681600000",
"number": "1003840505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 CONCORD RD",
"city": "YORK",
"state": "PA",
"postal_code": "174029001",
"telephone_number": "717-812-7800",
"fax_number": "717-812-7811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4222 LINCOLN HWY",
"city": "YORK",
"state": "PA",
"postal_code": "174068083",
"telephone_number": "717-812-7800",
"fax_number": "717-812-7811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "MICHAEL",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2017-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "PA",
"license": "MD023752E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY-WMG",
"identifier": "1142793",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER",
"identifier": "36693",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH 65 PA",
"identifier": "0068412000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY-WMG",
"identifier": "1517480",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000985796",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "086178",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI-WMG",
"identifier": "348556",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY - WMG",
"identifier": "30115669",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4545155",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY - YH",
"identifier": "30120490",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY-YHOBGYN",
"identifier": "20072397",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS-WMG",
"identifier": "03124601",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHNS HOPKINS",
"identifier": "032661",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "053883300",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST MD BCBS",
"identifier": "524955",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON-WMG",
"identifier": "81659",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.