Individual provider Active NPI

Stephanie Russo, AU.D.

  • Audiologist
  • Fishkill, NY
National Provider Identifier
1114212537
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
002335 Issued in NY
Practice address
18 Westage Business Ctr Dr
Fishkill, NY 12524-2219
Phone
(845) 897-3059
Fax
(845) 897-3254
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002335 NY Primary

Addresses

Primary practice location

18 Westage Business Ctr Dr
Fishkill, NY 12524-2219

Mailing address

18 Westage Business Ctr Dr
Fishkill, NY 12524-2219
Phone (845) 897-3059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110830000728 NY Practitioner - Qualified Audiologist 2668642653 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC CurrentSince Aug 1, 2018 Accepting new patients
Audiology Services Company USA, LLC CurrentSince Aug 1, 2018 Accepting new patients
Audiology Services Company USA, LLC Audiologist Current Accepting new patients

Locations

2501 Cottontail Ln
Somerset, NJ 08873
Phone (732) 529-7120

18 Westage Business Ctr Dr
Ste 16
Fishkill, NY 12524
Phone (845) 897-3059

515 Madison Ave
Rm 2302
New York, NY 10022
Phone (212) 421-0889

58 S Main St
Sayville, NY 11782
Phone (631) 750-6376

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1114212537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 WESTAGE BUSINESS CTR DR",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125242219",
            "telephone_number": "845-897-3059",
            "fax_number": "845-897-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 WESTAGE BUSINESS CTR DR",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125242219",
            "telephone_number": "845-897-3059",
            "fax_number": "845-897-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishkill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.