Sarra Russo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

016098 Issued in NY

Practice address

2876 Main St
Stratford, CT 06614-4984

Phone

(203) 219-3929

NPI assigned

Oct 16, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Sarra Koumasidis Former name

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stamford Health Medical Group IncGroup PAC ID 6901099746, 442 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stamford Hospital Hospital, Stamford, CT, CCN 070006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: sarra.koumasidis@xdr.hhchealthdirect.org

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.

• Stamford Health Medical Group Inc

  • General Practice Physician
  • Stamford, CT
  • NPI 1154633980
  Medicare reassignment Care Compare group

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

• Stamford Hospital

  • General Acute Care Hospital
  • Stamford, CT
  • NPI 1356331425
  Care Compare affiliation

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1245583160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2876 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144984",
            "telephone_number": "203-219-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "SARRA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARRA",
            "last_name": "KOUMASIDIS",
            "prefix": "MISS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ari Rubenstein, DPT
• Barry Rubin, LCSW
• Brendan Patrick Ruby, DDS
• Maureen Frances Ruby, DMD
• Gregory K Russo, MD
• Vanessa Russo, MSC
• Whitney Russo
• Eric Matthew Rutter, LMFT
• Ryders Rehabilitation, LLC
• Susan Rzucidlo, N.D.

• Physician Assistant in Stratford, CT
• Providers in Stratford, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.