NPIMap

Individual provider Active NPI

Melchiorre Joseph Russo, MD

  • Legal Medicine
  • Clifton, NJ
National Provider Identifier
1245291277
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
MA48796 Issued in NJ
Practice address
128 Valley Rd
Clifton, NJ 07013-1121
Phone
(973) 279-5116
Fax
(973) 279-8899
NPI assigned
Mar 29, 2006
Last updated
Jul 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X MA48796 NJ Primary

Addresses

Primary practice location

128 Valley Rd
Clifton, NJ 07013-1121

Mailing address

128 Valley Rd
Clifton, NJ 07013-1121
Phone (973) 279-5116

Other identifiers 1

IdentifierTypeStateIssuer
2103907MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050926000252 NJ Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3476587783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

128 Valley Rd
Clifton, NJ 07013-1169
Phone (973) 279-5116

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.94 of 100Reported as individual
Quality
88.01
Improvement activities
40
Cost
77.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA48796NJMDLegal Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
2020 Route 23 Operating Company LLC Past Accepting new patients
Hazel Street Operations LLC Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1245291277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 VALLEY RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131121",
            "telephone_number": "973-279-5116",
            "fax_number": "973-279-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 VALLEY RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131121",
            "telephone_number": "973-279-5116",
            "fax_number": "973-279-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "MELCHIORRE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NJ",
            "license": "MA48796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2103907",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.