Jonathan Matt Russo, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

49964 Issued in MA

Practice address

47 Obery St
Suite 201
Plymouth, MA 02360-2229

Phone

(508) 747-1560

Fax

(508) 747-5155

NPI assigned

Apr 27, 2006

Last updated

Aug 25, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Gastroenterology

Education

University of Massachusetts Medical School, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrusso251800@direct.bilh.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jordan Physician Associates, Inc.

  • Family Medicine Physician
  • Plymouth, MA
  • NPI 1538145131
  Medicare reassignment Care Compare group NPD
• Digestive Disease Associates PC

  • Gastroenterology Physician
  • Plymouth, MA
  • NPI 1174700421
  Authorized official Same address or phone
• Jordan Physician Associates, Inc.

  dba BIDH-Plymouth Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Plymouth, MA
  • NPI 1194263186
  NPD

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

• Beth Israel Deaconess Hospital Plymouth, Inc.

  • General Acute Care Hospital
  • Plymouth, MA
  • NPI 1043299001
  Care Compare affiliation

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1184681892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 OBERY ST",
            "address_2": "SUITE 201",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "02360",
            "telephone_number": "508-747-1560",
            "fax_number": "508-747-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 OBERY ST",
            "address_2": "SUITE 201",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602229",
            "telephone_number": "508-747-1560",
            "fax_number": "508-747-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JONATHAN",
        "middle_name": "MATT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "49964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3020835",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rudy Enterprises, Inc. (Comfort Keepers)
• Charles Ruisi
• William David Rumbaugh Jr., M.D.
• Christine Russo
• Cristy L. Cox Russo, PH.D.
• Ruth C. Rowbotham, Psy.D., LLC
• Melinda Rutherford
• Ryan Orthodontics PC
• Elizabeth M Ryan, ED.D.
• Lily Margaret Ryan

• Gastroenterology Physician in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Gastroenterology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.