Individual provider Active NPI

Joseph Michael Russo Jr., PA

  • Physician Assistant
  • Springfield, VT
National Provider Identifier
1366322950
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
25 Ridgewood Rd
Springfield, VT 05156-3050
Phone
(802) 885-2151
NPI assigned
Sep 4, 2025
Last updated
Oct 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X VT Primary

Addresses

Primary practice location

25 Ridgewood Rd
Springfield, VT 05156-3050

Mailing address

PO Box 203
Great Meadows, NJ 07838-0203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251212003670 VT Practitioner - Physician Assistant 4284128513 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Hospital Inc.Group PAC ID 6507760337, 63 clinicians

Practice addresses (Care Compare)

25 Ridgewood Rd
Springfield, VT 05156-3050
Phone (802) 885-2151

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Hospital CurrentSince Dec 30, 2025 Accepting new patients
Springfield Hospital .Inc CurrentSince Nov 1, 2025 Accepting new patients

Locations

25 Ridgewood Rd
Springfield, VT 05156
Phone (780) 281-9593

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1756944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1366322950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 203",
            "city": "GREAT MEADOWS",
            "state": "NJ",
            "postal_code": "078380203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 RIDGEWOOD RD",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051563050",
            "telephone_number": "802-885-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VT

Sources for this page

Verify at the official NPI Registry.