Individual provider Active NPI

Nicholas Anthony Russo, DO

  • Anesthesiology Physician
  • Buffalo, NY
National Provider Identifier
1487282695
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
329786-01 Issued in NY
Practice address
Elm and Carlton St
Buffalo, NY 14263
Phone
(716) 845-2300
NPI assigned
Apr 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 329786-01 NY
Anesthesiology Physician 207L00000X 329786-01 NY Primary

Addresses

Primary practice location

Elm and Carlton St
Buffalo, NY 14263

Mailing address

665 Elm St
Buffalo, NY 14203-1104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NY2 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

Enrollment IDStateProvider typePAC IDDetails
I20250214000149 IL Practitioner - Anesthesiology 6709321565 Reassigns benefits to 2 organizations
I20250728000636 NY Practitioner - Pain ManagementPractitioner - Anesthesiology 6709321565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roswell Park Cancer InstituteGroup PAC ID 3577475110, 487 clinicians

Practice addresses (Care Compare)

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
329786-01NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Jan 1, 2025 Accepting new patients
University of Chicago CurrentSince Jan 1, 2025 Accepting new patients
The University of Chicago Medical Center CurrentSince Jan 1, 2025 Accepting new patients
Roswell Park Cancer Institute CurrentSince Aug 1, 2025 Accepting new patients
Roswell Park Cancer Institute CurrentSince Aug 1, 2025 Accepting new patients

Locations

180 Harvester Dr
Ste 110
Burr Ridge, IL 60527
Phone (773) 702-1061

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1487282695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 ELM ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14263",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "NICHOLAS",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "329786-01",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "329786-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.