Nicole Russo, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01532600 Issued in NJ

Practice address

2123 Highway 35
Sea Girt, NJ 08750-1003

Phone

(732) 449-2001

Fax

(732) 449-2238

NPI assigned

Apr 21, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Strive Physical Therapy Specialists LLC

  • Physical Therapy Clinic/Center
  • Moorestown, NJ
  • NPI 1023609955

  Physical Therapist

  Medicare reassignment NPD
• Strive Physical Therapy Specialists LLC

  • Durable Medical Equipment & Medical Supplies
  • Moorestown, NJ
  • NPI 1417745563
  NPD
• Strive Physical Therapy Specialists LLC

  • Physical Therapy Clinic/Center
  • Philadelphia, PA
  • NPI 1659962587

  Physical Therapist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1013337864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 STRAWBRIDGE DR STE 100",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080574602",
            "telephone_number": "856-677-4000",
            "fax_number": "856-234-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 HIGHWAY 35",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087501003",
            "telephone_number": "732-449-2001",
            "fax_number": "732-449-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "NICOLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01532600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Roberts, HIS
• John Joseph Rocha, PT, DPT
• Maria Rondinaro, LCSW
• Rachelle Ross, PT, DPT
• Mary Kathleen Russo, D.M.D
• Alicja Rypien, DC
• Linda Audrey Sarason, M.A.CCC-SLP
• Bruce Allen Schuster, O.D.
• Sea Girt Dental Associates, L.L.C.
• Seaview Medical Associates, LLC

• Physical Therapist in Sea Girt, NJ
• Providers in Sea Girt, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.