Individual provider Active NPI

Magdala Limage Russo, CRNA

  • Certified Registered Nurse Anesthetist
  • Sacramento, CA
National Provider Identifier
1215176995
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95000420 Issued in CA
Practice address
4150 V St Ste 1200
Sacramento, CA 95817-1460
Phone
(916) 456-1450
NPI assigned
Feb 19, 2009
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AC002636 MD
Certified Registered Nurse Anesthetist 367500000X ARNP9170477 FL
Certified Registered Nurse Anesthetist 367500000X 95000420 CA Primary

Addresses

Primary practice location

4150 V St Ste 1200
Sacramento, CA 95817-1460

Mailing address

1613 Harrison Pkwy
Sunrise, FL 33323-2896
Phone (954) 838-2587

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MA, NY, DC, MD, VA6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20090330000380 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365509718 Reassigns benefits to 2 organizations
I20160831002635 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365509718 Reassigns benefits to 1 organization
I20190312002287 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365509718
I20191203002936 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365509718 Reassigns benefits to 1 organization
I20191203003033 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365509718 Reassigns benefits to 1 organization
I20240510003294 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365509718

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9170477FLMDCertified Registered Nurse Anesthetist
AC002636MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc CurrentSince Jan 1, 2019 Accepting new patients
Metrowest Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 28, 2018 Accepting new patients
St Lucie Anesthesia Associates LLC CurrentSince Jul 14, 2019 Accepting new patients
Albany Medical College Nurse Anesthetist, Certified Registered CurrentSince Feb 18, 2019 Accepting new patients
Albany Medical College CurrentSince Feb 18, 2019 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Feb 10, 2021 Accepting new patients
Albany Medical College Current Accepting new patients
St. Lucie Anesthesia Associates, LLC CurrentSince Jul 14, 2019 Accepting new patients
First Colonies Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 30, 2019 Accepting new patients
St Lucie Anesthesia Associates LLC Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Feb 10, 2021 Accepting new patients

Locations

3995 NW Goldenrod Rd
Jensen Beach, FL 34957
Phone (772) 497-0020

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-0793

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

8600 Old Georgetown Rd
Bethesda, MD 20814
Phone (301) 896-2578

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770

8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

Interoperability endpoints

  • Direct secure messaging: mlimagerusso567796@direct.hopkinsmedicine.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1215176995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 HARRISON PKWY",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232896",
            "telephone_number": "954-838-2587",
            "fax_number": "954-858-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 V ST STE 1200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-456-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIMAGE RUSSO",
        "first_name": "MAGDALA",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-19",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "AC002636",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9170477",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.