Individual provider Active NPI

Matthew Russo

  • Certified Registered Nurse Anesthetist
  • Bethlehem, PA
National Provider Identifier
1356719652
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN619623 Issued in PA
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

Updated by the provider on Sep 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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 PCGroup PAC ID 1355254533, 283 clinicians

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 Hospital, Coaldale, PA, CCN 390183
  • Geisinger St. Luke'S Hospital Hospital, Orwigsburg, PA, CCN 390332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN619623PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group Current Accepting new patients
Northeastern Anesthesia Physicians P.C. CurrentSince Apr 1, 2016 Accepting new patients
Anesthesia Specialists of Bethlehem, PC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2015 Accepting new patients
Associates in Anesthesia, Inc. CurrentSince May 1, 2018 Accepting new patients
Tower Health Medical Group CurrentSince Feb 11, 2019 Accepting new patients
Tower Health Medical Group CurrentSince Feb 11, 2019 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

  • FHIR API: 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.

Hospital & facility affiliations 2

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": "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.

Verify at the official NPI Registry.