Individual provider Active NPI

Amy L Russo, HIS

  • Hearing Instrument Specialist
  • Watchung, NJ
National Provider Identifier
1174407704
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
25MG00157600 Issued in NJ
Practice address
495 Watchung Ave
Watchung, NJ 07069-4945
Phone
(908) 561-1247
NPI assigned
Aug 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 25MG00157600 NJ Primary

Addresses

Primary practice location

495 Watchung Ave
Watchung, NJ 07069-4945

Mailing address

402 May Ave
South Plainfield, NJ 07080-5115
Phone (908) 759-8062

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

LicenseStateTypeSpecialty
25MG00157600NJMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1174407704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 MAY AVE",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805115",
            "telephone_number": "908-759-8062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 WATCHUNG AVE",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070694945",
            "telephone_number": "908-561-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NJ",
            "license": "25MG00157600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watchung, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.