Active NPI
Andrea Russo
- Audiologist
- New York, NY
National Provider Identifier
1336652056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- Practice address
- 1421 3Rd Ave Apt 4
New York, NY 10028-1933 - Phone
- (212) 792-3900
- NPI assigned
- Nov 16, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | NY | Primary |
Addresses
Primary practice location
1421 3Rd Ave Apt 4
New York, NY 10028-1933
Mailing address
2 Greenwood LN
Woodbury, NY 11797-2630
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181127000543 | NY | Practitioner - Qualified Audiologist | 8022362300 |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3022 Merrick Rd
Wantagh, NY 11793-4320
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510790400000",
"number": "1336652056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 GREENWOOD LN",
"city": "WOODBURY",
"state": "NY",
"postal_code": "117972630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 3RD AVE APT 4",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100281933",
"telephone_number": "212-792-3900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "ANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-16",
"last_updated": "2017-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.