Individual provider Active NPI

Frank David Russo, M.D.

  • Interventional Cardiology Physician
  • Keesler Afb, MS
National Provider Identifier
1225369648
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
26240 Issued in MS
Practice address
301 Fisher St
Keesler Afb, MS 39534-2508
Phone
(228) 376-3807
Fax
(228) 376-0105
NPI assigned
Jan 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 26240 MS
Cardiovascular Disease Physician 207RC0000X 26240 MS
Cardiovascular Disease Physician 207RC0000X MD.31539 AL
Interventional Cardiology Physician 207RI0011X 26240 MS Primary

Addresses

Primary practice location

301 Fisher St
Keesler Afb, MS 39534-2508

Mailing address

301 Fisher St
Keesler Afb, MS 39534-2508
Phone (228) 376-3807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20240910004860 MS Practitioner - Cardiovascular Disease (Cardiology) 4688945066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Alabama School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians

Practice addresses (Care Compare)

1721 Medical Park Dr
Biloxi, MS 39532-2109
Phone (228) 392-7429

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.31539ALMDCardiovascular Disease Physician
26240MSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Health System CurrentSince Sep 1, 2024 Accepting new patients

Locations

1721 Medical Park Dr
Ste 200
Biloxi, MS 39532
Phone (228) 248-2572

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

2 Doctors Dr
Ocean Springs, MS 39564
Phone (228) 372-8270

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1225369648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-3807",
            "fax_number": "228-376-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-3807",
            "fax_number": "228-376-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "FRANK",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-25",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "26240",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "26240",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "MD.31539",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MS",
            "license": "26240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keesler Afb, MS

Sources for this page

Verify at the official NPI Registry.