Individual provider Active NPI

Jarrod A Russo, CRNA

  • Certified Registered Nurse Anesthetist
  • Albuquerque, NM
National Provider Identifier
1164517090
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
947329 Issued in NY
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

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
4137575OtherTNBCBS OF TN
P00362861OtherRAILROAD MEDICARE
3636848MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200415003583 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800898610 Reassigns benefits to 1 organization
I20240918000246 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800898610 Reassigns benefits to 1 organization

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
North American Partners in Anesthesia LLPGroup PAC ID 7719885771, 427 clinicians

Practice addresses (Care Compare)

321 Genesee St
Oneida, NY 13421-2611
Phone (315) 363-6000

Hospital & facility affiliations

  • Oneida Health Hospital Hospital, Oneida, NY, CCN 330115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
12234TNMDPhysical Therapist
APN12234TNMDCertified Registered Nurse Anesthetist
RN116970TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc CurrentSince Oct 2, 2023 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Aug 9, 2024 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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.

Verify at the official NPI Registry.