Stephen A Russo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA057357 Issued in PA

Practice address

1500 Highlands Dr
Lititz, PA 17543-7694

Phone

(717) 988-0000

Fax

(717) 782-5716

NPI assigned

Jan 23, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

93.46 of 100Reported as group

Quality

92.17

Promoting interoperability

100

Improvement activities

40

Cost

78.87

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: srusso514451@upmc.direct-ci.com

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.

• Pinnacle Health Emergency Department Services LLC

  • Emergency Medicine Physician
  • Harrisburg, PA
  • NPI 1487693404
  Medicare reassignment
• Conestoga Emergency Physicians LLC

  • Emergency Medicine Physician
  • Lancaster, PA
  • NPI 1275582843

  Physician Assistant

  NPD (past)
• New Jersey/Pennsylvania Em-I Medical Services, P.C.

  • Emergency Medicine Physician
  • Lititz, PA
  • NPI 1003930686

  Physician Assistant

  NPD (past)
• Red Rose Emergency Physicians LLC

  • Emergency Medicine Physician
  • Lititz, PA
  • NPI 1003865817

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1063783074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 HIGHLANDS DR",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 HIGHLANDS DR",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437694",
            "telephone_number": "717-988-0000",
            "fax_number": "717-782-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-23",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106297",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103476544",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srusso64700@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "1500 Highlands Dr",
            "city": "Lititz",
            "state": "PA",
            "country_code": "US",
            "postal_code": "175437694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rothsville Counseling
• Rothsville Fire Company No 1
• Kyle A Russell, PA
• Daniel Alexander Russo, MD
• Marc S Russo, M.D.
• Madalene Rutherford
• Megan Louise Sabol, DPT
• Dale W Sailer, M.D.
• Tipu Faiz Muhammed Saleem, MD
• Maryam Salimi-Tari

• Physician Assistant in Lititz, PA
• Providers in Lititz, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.