Active NPI
Patricia J Russo, BC-HIS
- Hearing Instrument Specialist
- Pensacola, FL
National Provider Identifier
1164578506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- AS 1379
- Practice address
- 115 N Palafox St
Pensacola, FL 32502-4838 - Phone
- (850) 438-4092
- Fax
- (850) 438-4095
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | AS 1379 | FL | Primary |
| Other Technician | 247200000X | AS 1379 | FL |
Addresses
Primary practice location
115 N Palafox St
Pensacola, FL 32502-4838
Mailing address
115 N Palafox St
Pensacola, FL 32502-4838
Phone (850) 438-4092
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 085155800 | Medicaid | FL | |
| 161297600 | Other | FL | ACS |
| T 0094 | Other | FL | BCBS |
| J0195 | Other | FL | UAW |
| 085429800 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AS 1379 | FL | MD | Other Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chac Inc | Hearing Instrument Specialist | Past | Accepting new patients |
| Audiology Distribution, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Audiologist-Hearing Aid Fitter
- Dublin, OH
- NPI 1164707998
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478736000000",
"number": "1164578506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 N PALAFOX ST",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325024838",
"telephone_number": "850-438-4092",
"fax_number": "850-438-4095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 N PALAFOX ST",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325024838",
"telephone_number": "850-438-4092",
"fax_number": "850-438-4095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "PATRICIA",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "BC-HIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2016-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "FL",
"license": "AS 1379",
"primary": true
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "FL",
"license": "AS 1379",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "085155800",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACS",
"identifier": "161297600",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "T 0094",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UAW",
"identifier": "J0195",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "085429800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.