Andrew Russo, D.O.

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

224966 Issued in NY

Practice address

433 77TH St
Brooklyn, NY 11209-3205

Phone

(718) 238-1155

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417984295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 77TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093205",
            "telephone_number": "718-238-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 77TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093205",
            "telephone_number": "718-238-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "NY",
            "license": "224966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colette Russen, FNP
• Thomas J Russi, MD
• Garrett Russikoff
• Adriana Russo
• Amanda D Russo, SLP
• Angelina Savina Russo, MS
• Arthur Christopher Russo, PH.D.
• Charles Lance Russo, DPM
• Christen M Russo, MD
• Christopher Joseph Russo

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.