Individual provider Active NPI

Patricia Renee Russo

  • Mental Health Counselor
  • Tonawanda, NY
National Provider Identifier
1114656212
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
015556 Issued in NY
Practice address
100 Niagara St
Tonawanda, NY 14150-1104
Phone
(716) 831-1850
NPI assigned
Jun 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 015556 NY Primary

Addresses

Primary practice location

100 Niagara St
Tonawanda, NY 14150-1104

Mailing address

55 Dodge Rd
Getzville, NY 14068-1205
Phone (716) 831-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250205000861 NY Practitioner - Mental Health Counselor 6608306733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Horizon Health Services IncGroup PAC ID 5698689925, 144 clinicians

Practice addresses (Care Compare)

3020 Bailey Ave
Buffalo, NY 14215-2814
Phone (716) 833-3622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015556NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Health Services Inc CurrentSince Jan 3, 2025 Accepting new patients

Locations

3020 Bailey Ave
Cheektowaga, NY 14215
Phone (716) 831-0200

55 Dodge Rd
Getzville, NY 14068
Phone (716) 650-5100

100 Niagara St
Tonawanda, NY 14150
Phone (716) 343-1888

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEGDAA

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.

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1114656212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DODGE RD",
            "city": "GETZVILLE",
            "state": "NY",
            "postal_code": "140681205",
            "telephone_number": "716-831-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NIAGARA ST",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141501104",
            "telephone_number": "716-831-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "PATRICIA",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "015556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.