Individual provider Active NPI

Patrick Russo, PT

  • Physical Therapist
  • Midlothian, VA
National Provider Identifier
1417472317
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305211362 Issued in VA
Practice address
13801 St Francis Blvd Ste 200
Midlothian, VA 23114-3206
Phone
(804) 320-4604
Fax
(804) 287-2786
NPI assigned
Aug 11, 2017
Last updated
Apr 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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 2305211362 VA Primary

Addresses

Primary practice location

13801 St Francis Blvd Ste 200
Midlothian, VA 23114-3206

Mailing address

1115 Boulders Pkwy Ste 200
North Chesterfield, VA 23225-4067
Phone (804) 915-4607

Other practice location 1

8206 Leesburg Pike Ste 402
Vienna, VA 22182-2614
Phone (703) 356-3470

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200520001136 VA Practitioner - Physical Therapist in Private Practice 8224469531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthovirginia IncGroup PAC ID 0547157224, 570 clinicians

Practice addresses (Care Compare)

15300 E W Rd
Midlothian, VA 23114
Phone (804) 379-2414

8200 Meadowbridge Rd
Mechanicsville, VA 23116-2337

9369 Atlee Rd
Suite 3107
Mechanicsville, VA 23116-2400
Phone (804) 440-4878

Merit-based Incentive Payment System (MIPS)

Final score
90.85 of 100Reported as group
Quality
90.74
Promoting interoperability
100
Improvement activities
40
Cost
78.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305211362VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthovirginia, Inc CurrentSince Jun 1, 2020 Accepting new patients
Orthovirginia Inc Physical Therapist Current Accepting new patients
Orthovirginia, Inc. Past Accepting new patients

Locations

8200 Meadowbridge Rd
Ste 200
Mechanicsville, VA 23116
Phone (804) 560-5595

13801 St Francis Blvd
Ste 200
Midlothian, VA 23114
Phone (804) 320-4064

1115 Boulders Pkwy
Ste 200
North Chesterfield, VA 23225
Phone (804) 327-9242

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1417472317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BOULDERS PKWY STE 200",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232254067",
            "telephone_number": "804-915-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 ST FRANCIS BLVD STE 200",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231143206",
            "telephone_number": "804-320-4604",
            "fax_number": "804-287-2786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8206 Leesburg Pike Ste 402",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221822614",
            "country_code": "US",
            "telephone_number": "703-356-3470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "PATRICK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-11",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.