Active NPI
Jarrod A Russo, CRNA
- Certified Registered Nurse Anesthetist
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 947329
- Practice address
- 4520 Montgomery Blvd NE Ste 6
Albuquerque, NM 87109-1291 - Phone
- (505) 501-4710
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | APN12234 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | RN116970 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | CRNA-01219 | NM | |
| Certified Registered Nurse Anesthetist | 367500000X | 947329 | NY | Primary |
Addresses
Primary practice location
4520 Montgomery Blvd NE Ste 6
Albuquerque, NM 87109-1291
Mailing address
4520 Montgomery Blvd NE Ste 6
Albuquerque, NM 87109-1291
Phone (505) 501-4710
Other practice location 1
2341 McCallie Ave
Suite 402
Chattanooga, TN 37404-3239
Phone (423) 698-3309
Other practice location 2
321 Genesee St
Oneida, NY 13421-2611
Phone (315) 363-6000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4137575 | Other | TN | BCBS OF TN |
| P00362861 | Other | RAILROAD MEDICARE | |
| 3636848 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, NY
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
321 Genesee St
Oneida, NY 13421-2611
Phone (315) 363-6000
Hospital & facility affiliations
- Oneida Health Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12234 | TN | MD | Physical Therapist |
| APN12234 | TN | MD | Certified Registered Nurse Anesthetist |
| RN116970 | TN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SMH Physician Services Inc | Current | Accepting new patients | |
| North American Partners in Anesthesia LLP | Current | Accepting new patients | |
| Anesthesia Specialists of Albuquerque | Past | Accepting new patients | |
| Anesthesiologists Associated PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Anesthesiologists Associated PC | Past | Accepting new patients |
Locations
2600 Laurel Rd E
North Venice, FL 34275
Phone (941) 261-9000
1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565
1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507
7 Southwoods Blvd
Ste 4
Albany, NY 12211
3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341
321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020
Organizations & group practices 5
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.
-
- Anesthesiology Physician
- Melville, NY
- NPI 1649264706
-
- Internal Medicine Physician
- Sarasota, FL
- NPI 1346295292
-
- Anesthesiology Physician
- Albuquerque, NM
- NPI 1831104215
-
- Certified Registered Nurse Anesthetist
- Chattanooga, TN
- NPI 1043278443
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Chattanooga, TN
- NPI 1518923705
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oneida, NY
- NPI 1962408203
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723161600000",
"number": "1164517090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4520 MONTGOMERY BLVD NE STE 6",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091291",
"telephone_number": "505-501-4710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4520 MONTGOMERY BLVD NE STE 6",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091291",
"telephone_number": "505-501-4710"
}
],
"practiceLocations": [
{
"address_1": "2341 McCallie Ave",
"address_2": "Suite 402",
"address_purpose": "LOCATION",
"city": "Chattanooga",
"state": "TN",
"postal_code": "374043239",
"country_code": "US",
"telephone_number": "423-698-3309",
"fax_number": "423-624-6355",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "321 Genesee St",
"address_purpose": "LOCATION",
"city": "Oneida",
"state": "NY",
"postal_code": "134212611",
"country_code": "US",
"telephone_number": "315-363-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSSO",
"first_name": "JARROD",
"middle_name": "A",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2024-08-09",
"certification_date": "2024-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "APN12234",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "RN116970",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NM",
"license": "CRNA-01219",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NY",
"license": "947329",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TN",
"identifier": "4137575",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00362861",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3636848",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.