Robert D. Russo, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

016805 Issued in CT

Practice address

75 Kings Highway Cutoff
Suite 1a
Fairfield, CT 06824-5340

Phone

(203) 815-1877

Fax

(203) 538-5246

NPI assigned

Jun 30, 2005

Last updated

Mar 7, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• RDR Radiology LLC

  • Diagnostic Radiology Physician
  • Fairfield, CT
  • NPI 1649778614
  NPD Authorized official
• Paul a. Aiello, MD, PC

  dba Prince Street Imaging

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • New Haven, CT
  • NPI 1972552768

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1114924693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4695 MAIN ST",
            "address_2": "SUITE 5",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066061802",
            "telephone_number": "203-538-5233",
            "fax_number": "203-538-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 KINGS HIGHWAY CUTOFF",
            "address_2": "SUITE 1A",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245340",
            "telephone_number": "203-815-1877",
            "fax_number": "203-538-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "ROBERT",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "016805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001168053",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Rush, APRN
• Adam Russak, MD
• Sally W Russell, RDH
• Jane A. Russo, D.M.D.
• Luann Russo, CNM
• Jacqueline Renee Ruzga, DOCTOR OF CHIROPRACT
• Afshin Saadatisohi
• Ramsey Saba, M.D.
• Kirsten Sabrowski, LCSW
• Sacred Heart University, Inc (Sacred Heart University Physical Therapy Specialists)

• Diagnostic Radiology Physician in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Diagnostic Radiology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.

Verify at the official NPI Registry.