Individual provider Active NPI

Wendy R Russo, DC

  • Chiropractor
  • Rockville Centre, NY
National Provider Identifier
1326075052
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X-007171 Issued in NY
Practice address
100 N Centre Ave
Suite 202
Rockville Centre, NY 11570-3937
Phone
(516) 763-2600
Fax
(516) 763-4218
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X-007171 NY Primary

Addresses

Primary practice location

100 N Centre Ave
Suite 202
Rockville Centre, NY 11570-3937

Mailing address

100 N Centre Ave
Suite 202
Rockville Centre, NY 11570-3937
Phone (516) 763-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060907000441 NY Practitioner - Chiropractic 8729082607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wendy and Michael Russo Chiropractors, PCGroup PAC ID 0648274522, 2 clinicians

Practice addresses (Care Compare)

100 N Centre Ave
Suite 202
Rockville Centre, NY 11570-6301
Phone (516) 763-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X-007171NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wendy and Michael Russo Chiropractors, PC Chiropractor CurrentSince Oct 19, 1995 Accepting new patients

Locations

85 N Park Ave
Rockville Centre, NY 11570
Phone (516) 763-2600

100 N Centre Ave
Ste 202
Rockville Ctr, NY 11570
Phone (516) 665-1939

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1326075052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N CENTRE AVE",
            "address_2": "SUITE 202",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703937",
            "telephone_number": "516-763-2600",
            "fax_number": "516-763-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N CENTRE AVE",
            "address_2": "SUITE 202",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703937",
            "telephone_number": "516-763-2600",
            "fax_number": "516-763-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "WENDY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X-007171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.