Individual provider Active NPI

Gina F. Russo, PA-C

  • Physician Assistant
  • Concord, NH
National Provider Identifier
1295837334
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0562 Issued in NH
Practice address
250 Pleasant St Ste 6073
Concord, NH 03301-7539
Phone
(603) 227-7000
Fax
(603) 227-7191
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0562 NH Primary

Addresses

Primary practice location

250 Pleasant St Ste 6073
Concord, NH 03301-7539

Mailing address

250 Pleasant St Ste 6073
Concord, NH 03301-7539
Phone (603) 227-7000

Other names 1

  • Gina F. Grudinskas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060214000483 NH Practitioner - Physician Assistant 0042225930 Reassigns benefits to 1 organization
I20071204000199 MA Practitioner - Physician Assistant 0042225930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Hospital IncGroup PAC ID 6103721790, 572 clinicians

Practice addresses (Care Compare)

250 Pleasant St
Concord, NH 03301-2598

250 Pleasant St
Concord, NH 03301-7559
Phone (603) 230-3138

Hospital & facility affiliations

  • Concord Hospital Hospital, Concord, NH, CCN 300001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0562NHMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Women'S Hospital Current Accepting new patients
Concord Hospital, Inc. CurrentSince Jul 8, 2019 Accepting new patients
Concord Hospital, Inc. CurrentSince Jul 8, 2019 Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

246 Pleasant St
Concord, NH 03301
Phone (603) 224-1223

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

250 Pleasant St
Ofc
Concord, NH 03301

250 Pleasant St
Ste 6073
Concord, NH 03301
Phone 6032277000 ext. 3939

Interoperability endpoints

  • Direct secure messaging: russo.gina.bwh@direct.partners.masshiway.net

Organizations & group practices 6

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1295837334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PLEASANT ST STE 6073",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033017539",
            "telephone_number": "603-227-7000",
            "fax_number": "603-227-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PLEASANT ST STE 6073",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033017539",
            "telephone_number": "603-227-7000",
            "fax_number": "603-227-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "GINA",
        "middle_name": "F.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "GRUDINSKAS",
            "middle_name": "F.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.