Active NPI
Daniel Joseph Russo, MD
- Geriatric Medicine (Internal Medicine) Physician
- Briarwood, NY
National Provider Identifier
1316951882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 164191
- Practice address
- 14445 87TH Ave
Briarwood, NY 11435-3109 - Phone
- (718) 480-4024
- Fax
- (718) 480-4028
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 164191 | NY | Primary |
Addresses
Primary practice location
14445 87TH Ave
Briarwood, NY 11435-3109
Mailing address
68 The Dell
Searingtown, NY 11507
Phone (516) 621-4987
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01937044 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Parkway Hospital | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Forest Hills, NY
- NPI 1124060538
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264636800000",
"number": "1316951882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 THE DELL",
"city": "SEARINGTOWN",
"state": "NY",
"postal_code": "11507",
"telephone_number": "516-621-4987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14445 87TH AVE",
"city": "BRIARWOOD",
"state": "NY",
"postal_code": "114353109",
"telephone_number": "718-480-4024",
"fax_number": "718-480-4028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "DANIEL",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2010-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "NY",
"license": "164191",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01937044",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Briarwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.