Brian Russo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

60310413 Issued in WA

Practice address

751 NE Blakey Drive
Swedish Medical Center
Issaquah, WA 98027

Phone

(425) 394-0610

NPI assigned

Oct 19, 2012

Last updated

Nov 6, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eastside Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Issaquah, WA
  • NPI 1689683229
  Medicare reassignment NPD
• Swedish Health Services

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1689612954
  Medicare reassignment NPD
• Northwest Physician Associates PC

  • Physician Assistant
  • Arlington, WA
  • NPI 1275567919
  Medicare reassignment
• Providence Health & Services Washington

  dba Providence Medical Group SouthWest Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment
• DRX Wa Urgent Care Providers PLLC

  dba Immediate Clinic

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1487083713

  Physician Assistant

  NPD
• Providence Health & Services- Washington

  dba PMG NW Wa

  • General Practice Physician
  • Everett, WA
  • NPI 1124270715
  NPD
• Providence Health & Services-Washington

  dba PMG NW WA Cardiology

  • Cardiovascular Disease Physician
  • Everett, WA
  • NPI 1508000449
  NPD

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636156800000",
    "number": "1427301084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 NW SAMMAMISH RD",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278940",
            "telephone_number": "425-394-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKEY DRIVE",
            "address_2": "SWEDISH MEDICAL CENTER",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "98027",
            "telephone_number": "425-394-0610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 Rockefeller Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982011676",
            "country_code": "US",
            "telephone_number": "425-261-4940",
            "fax_number": "425-261-4932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "BRIAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-19",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "60310413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brusso1043119@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1330 Rockefeller Ave Ste 210",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicoleta Mihaela Rus, MD
• Mark Russel
• Karen Russell
• Kathryn Russell, MS, CCC-SLP
• Mara Russell, D.C.
• Karen Noreen Rutledge, LMP
• Scott Rutledge, LMFT
• RWW Pediatric Rehab Services LLC
• Kathrine Ryan, MD
• Melissa M Ryan, ATC

• Physician Assistant in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.