Paul Edward Russo Jr., M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

041302 Issued in CT

Practice address

1450 Chapel St
New Haven, CT 06511-4405

Phone

(203) 789-3469

NPI assigned

Jan 14, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in MA, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guidewell Emergency Medicine Doctors, LLCGroup PAC ID 8224352919, 88 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Guidewell Emergency Medicine Doctors, LLC

  • Urgent Care Clinic/Center
  • Winter Park, FL
  • NPI 1629497235
  Medicare reassignment Care Compare group NPD
• Lakes/National Emergency Physicians Inc

  • Emergency Medicine Physician
  • Holyoke, MA
  • NPI 1114426772
  Medicare reassignment NPD
• Guidewell Emergency Medicine Doctors, LLC

  • Radiology Clinic/Center
  • Winter Park, FL
  • NPI 1639973555
  NPD
• Hospital of Saint Raphael

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1548269624
  NPD (past)
• Saint Raphael Faculty Physicians II

  • Emergency Medicine Physician
  • New Haven, CT
  • NPI 1912193376
  NPD (past)

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427109859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 OLD FARMS E",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064577534",
            "telephone_number": "860-343-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114405",
            "telephone_number": "203-789-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "041302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline A Russell, LMSW
• Kerry S Russell, MD
• Raymond Richard Russell, MD
• Sage Russell
• Mark B Russi, MD
• Lauren Katharine Ruth, PH.D.
• Katherine Presley Rutland, APRN
• Will Rutland, M.D.
• Christine Bethany Ryan, MD, PHD
• Edward Robert Ryan, PH.D.

• Emergency Medicine Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Emergency Medicine Physician in Connecticut

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.