Trina Mary Russo, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

TR001571 Issued in MI

Practice address

20967 Kelly Rd
Eastpointe, MI 48021

Phone

(586) 779-8600

Fax

(586) 779-2019

NPI assigned

Dec 23, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI, DE2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Eastside Podiatry PLLC

  • Foot & Ankle Surgery Podiatrist
  • Saint Clair Shores, MI
  • NPI 1144377821
  Medicare reassignment NPD
• Mental Edge Counseling, LLC

  • Mental Health Counselor
  • Dover, DE
  • NPI 1699145854
  Medicare reassignment NPD
• Anthony V Benenati DPM PC

  • Podiatrist
  • Saint Clair Shores, MI
  • NPI 1992735252
  NPD (past)
• Michael E. Graham, DPM, PC

  dba Center for Foot & Ankle Disorders

  • Foot & Ankle Surgery Podiatrist
  • Shelby Township, MI
  • NPI 1194925321
  NPD (past)
• Tender Foot & Ankle Care PLLC

  • Podiatric Clinic/Center
  • Shelby TWP, MI
  • NPI 1699076455

  Podiatrist

  NPD (past)

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1174500862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39090 GARFIELD RD",
            "address_2": "STE 108",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480384093",
            "telephone_number": "586-779-8600",
            "fax_number": "586-779-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20967 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "48021",
            "telephone_number": "586-779-8600",
            "fax_number": "586-779-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "TRINA",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "TR001571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2760454",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS MICH",
            "identifier": "480E020980",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS MI",
            "identifier": "5505057",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emanuel James Rothis, D.D.S
• Sharda Rucker
• Runway Transportation
• Joya Gaddy Rush-Keli, LMSW
• Neha Russo
• Aeryn Lynn Rutt
• Saadia Siddiqui MD PC
• Sacred Heart Rehabilitation Center
• Sacred Heart Rehabilitation Center
• Safe and Gentle Hands LLC

• Podiatrist in Eastpointe, MI
• Providers in Eastpointe, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.
• 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.