Active NPI
Matthew Russo
- Certified Registered Nurse Anesthetist
- Bethlehem, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN619623
- Practice address
- 1 W Broad St
Suite 506
Bethlehem, PA 18018-5717 - Phone
- (610) 954-5810
- NPI assigned
- Sep 3, 2015
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN619623 | PA | Primary |
Addresses
Primary practice location
1 W Broad St
Suite 506
Bethlehem, PA 18018-5717
Mailing address
156 Turkey Rd
Kempton, PA 19529-8734
Phone (908) 304-5738
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151230000395 | PA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 0042512550 | Reassigns benefits to 4 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anesthesia Specialists of Bethlehem PC
Practice addresses (Care Compare)
100 Paramount Blvd
Orwigsburg, PA 17961-2202
Phone (610) 954-5810
360 W Riddle St
Coaldale, PA 18218-1027
Phone (610) 954-5810
500 St Lukes Dr
Lehighton, PA 18235-5000
Phone (866) 785-8537
801 Ostrum St
Bethlehem, PA 18015-1065
Phone (610) 954-5810
Hospital & facility affiliations
- St Luke'S Miners Memorial Hospital
- Geisinger St. Luke'S Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN619623 | PA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tower Health Medical Group | Current | Accepting new patients | |
| Northeastern Anesthesia Physicians P.C. | Current | Accepting new patients | |
| Anesthesia Specialists of Bethlehem, PC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Associates in Anesthesia, Inc. | Current | Accepting new patients | |
| Tower Health Medical Group | Current | Accepting new patients | |
| Tower Health Medical Group | Current | Accepting new patients | |
| Associates in Anesthesia | Past | Accepting new patients | |
| Anesthesia Specialists of Warren, LLC | Past | Accepting new patients |
Locations
1736 Hamilton St
Allentown, PA 18104
Phone (610) 770-8300
24 S 18th St
Allentown, PA 18104
Phone (610) 628-8372
1 W Broad St
Ste 506
Bethlehem, PA 18018
Phone 6109545810 ext. 3
1212 Baltimore Pike
Ste 200
Chadds Ford, PA 19317
Phone (610) 874-4147
30 Medical Center Blvd
Ste 305
Chester, PA 19013
Phone (610) 619-7411
801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200
420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637
2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/
Organizations & group practices 8
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.
-
- Anesthesiology Physician
- Bethlehem, PA
- NPI 1851349302
Nurse Anesthetist, Certified Registered, PA
-
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
- West Reading, PA
- NPI 1508940529
-
- Surgery Physician
- Wyomissing, PA
- NPI 1831954353
-
- Anesthesiology Physician
- Chadds Ford, PA
- NPI 1336470467
-
- Anesthesiology Physician
- Phillipsburg, NJ
- NPI 1104354422
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Coaldale, PA
- NPI 1437182847
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441238400000",
"number": "1356719652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "156 TURKEY RD",
"city": "KEMPTON",
"state": "PA",
"postal_code": "195298734",
"telephone_number": "908-304-5738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 W BROAD ST",
"address_2": "SUITE 506",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180185717",
"telephone_number": "610-954-5810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-03",
"last_updated": "2015-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "PA",
"license": "RN619623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bethlehem, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.