NPIMap

Individual provider Active NPI

Anthony Russo, M.D.

  • Internal Medicine Physician
  • Youngstown, OH
National Provider Identifier
1366890410
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.136883 Issued in OH
Practice address
500 Gypsy Lane
Youngstown, OH 44501
Phone
(330) 884-4250
Fax
(330) 884-0651
NPI assigned
May 31, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 35.136883 OH Primary

Addresses

Primary practice location

500 Gypsy Lane
Youngstown, OH 44501

Mailing address

130 Oak Tree Dr
Canfield, OH 44406-9295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190912002644 OH Practitioner - Internal Medicine 4789913930 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Jan 15, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Aug 1, 2019 Accepting new patients
Steward Medical Group Inc. Internal Medicine Current Accepting new patients
Steward Trumbull Memorial Hospital, Inc. Past Accepting new patients

Locations

1440 S Canfield Niles Rd
Austintown, OH 44515
Phone (234) 264-8080

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

1350 E Market St
Warren, OH 44483
Phone (330) 841-5969

1450 S Canfield Niles Rd
Youngstown, OH 44515
Phone (330) 270-2700

500 Gypsy Ln
Youngstown, OH 44504
Phone (330) 740-4572

Organizations & group practices 4

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 10

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": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1366890410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 OAK TREE DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GYPSY LANE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44501",
            "telephone_number": "330-884-4250",
            "fax_number": "330-884-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-31",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.136883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.