Paul Robert Russo, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1112141 Issued in TX

Practice address

34800 Bob Wilson Dr
San Diego, CA 92134-1098

Phone

(619) 532-8109

NPI assigned

Jun 13, 2006

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• American Current Care, P.a.

  • Health Service Clinic/Center
  • Addison, TX
  • NPI 1275651002
  Medicare reassignment NPD
• American Current Care PA

  • Urgent Care Clinic/Center
  • Freeport, TX
  • NPI 1942790662
  NPD
• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • San Marcos, CA
  • NPI 1588489975
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1164465753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130192",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920130192",
            "telephone_number": "760-918-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "PAUL",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1112141",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP10524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Rae Russo, PHARMD
• Hana Marie Russo, MD
• Ivana Russo, RN
• John Kerch Russo, RN
• Mitchell Russo, DPT
• Riley Rosemary Russo
• Ryan Russo
• Terri A. Russo, MD
• Ryan Anthony Rust, PA-C
• Derek Scott Rustich, DPT

• Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.