Individual provider Active NPI

Alexandria Marie Russo, PT

  • Physical Therapist
  • Stoneham, MA
National Provider Identifier
1396626909
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL88686 Issued in MA
Practice address
92 Montvale Ave Ste 1400
Stoneham, MA 02180-3629
Phone
(781) 279-7040
Fax
(781) 279-8430
NPI assigned
Sep 10, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL88686 MA Primary

Addresses

Primary practice location

92 Montvale Ave Ste 1400
Stoneham, MA 02180-3629

Mailing address

92 Montvale Ave Ste 1400
Stoneham, MA 02180-3629
Phone (781) 279-7040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250926001113 MA Practitioner - Physical Therapist in Private Practice 6406351782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Surgery, IncGroup PAC ID 0244207645, 25 clinicians

Practice addresses (Care Compare)

405 Pearl St
Malden, MA 02148-6644
Phone (781) 321-8785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL88686MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Surgery, Inc CurrentSince Oct 13, 2025 Accepting new patients

Locations

100 S Shore Dr
Ste 200
East Haven, CT 06512
Phone (217) 433-2804

405 Pearl St
Malden, MA 02148
Phone (781) 321-8785

92 Montvale Ave
Ste 1400
Stoneham, MA 02180
Phone (781) 279-7040

Interoperability endpoints

  • Direct secure messaging: arusso148242@tuftsmedicine.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1396626909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE STE 1400",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803629",
            "telephone_number": "781-279-7040",
            "fax_number": "781-279-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE STE 1400",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803629",
            "telephone_number": "781-279-7040",
            "fax_number": "781-279-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "ALEXANDRIA",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL88686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.