Active NPI
Frank T Russo, PT, DPT
- Physical Therapist
- North Myrtle Beach, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 052834
- Practice address
- 1621 Highway 17 N
North Myrtle Beach, SC 29582-2229 - Phone
- (843) 353-3460
- Fax
- (843) 353-3461
- NPI assigned
- Sep 18, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12580 | SC | |
| Physical Therapist | 225100000X | 052834 | NY | Primary |
Addresses
Primary practice location
1621 Highway 17 N
North Myrtle Beach, SC 29582-2229
Mailing address
210 Village Center Blvd Ste 140
Myrtle Beach, SC 29579-6706
Phone (843) 353-3460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, NY
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2024
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
7524 3Rd Ave
Brooklyn, NY 11209-3104
Phone (718) 816-6500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 052834 | NY | MD | Pharmacist |
| 12580 | SC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthosc, LLC | Multi-Specialty | Current | Accepting new patients |
| J. Lamendola Physical Therapy, P.C. | Multi-Specialty | Current | Accepting new patients |
| Orthosc, LLC | Multi-Specialty | Current | Accepting new patients |
| J P L TLC 76 &3 Corp | Current | Accepting new patients | |
| One on One Physical Therapy Services PLLC | Multi-Specialty | Past | Accepting new patients |
| MFS Orthopedics PC | Multi-Specialty | Past | Accepting new patients |
| Orthosc, LLC | Past | Accepting new patients |
Locations
7524 3rd Ave
Brooklyn, NY 11209
1297 Clove Rd
Staten Island, NY 10301
Phone (718) 447-8060
236 Richmond Valley Rd
Ste 16
Staten Island, NY 10309
2376 Cypress Cir
Ste 300
Conway, SC 29526
Phone (843) 347-7222
210 Village Center Blvd
Ste 140
Myrtle Beach, SC 29579
Phone (843) 333-8385
210 Village Center Blvd
Ste 100
Myrtle Beach, SC 29579
Phone (843) 491-4937
1621 Highway 17 N
North Myrtle Beach, SC 29582
Phone (843) 335-3346
Interoperability endpoints
- https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4
Organizations & group practices 7
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.
-
- Physical Therapist
- Staten Island, NY
- NPI 1982004958
Multi-Specialty
-
- Physical Medicine & Rehabilitation Physician
- Brooklyn, NY
- NPI 1053048496
-
- Orthopaedic Surgery Physician
- North Myrtle Beach, SC
- NPI 1568100691
-
- Physical Therapist
- Brooklyn, NY
- NPI 1740423219
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1164259552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 VILLAGE CENTER BLVD STE 140",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295796706",
"telephone_number": "843-353-3460",
"fax_number": "843-353-3461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 HIGHWAY 17 N",
"city": "NORTH MYRTLE BEACH",
"state": "SC",
"postal_code": "295822229",
"telephone_number": "843-353-3460",
"fax_number": "843-353-3461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "FRANK",
"middle_name": "T",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-18",
"last_updated": "2024-09-23",
"certification_date": "2024-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "SC",
"license": "12580",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "052834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.