Carly Russo, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA054790 Issued in PA

Practice address

107 Gamma Dr Ste 210
Pittsburgh, PA 15238-2936

Phone

(412) 963-6677

NPI assigned

Mar 15, 2011

Sex

Female

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

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Group practices

Geskin Medical LLCGroup PAC ID 4981006640, 20 clinicians

Logos Wound Care Solutions PA LLCGroup PAC ID 6901399401, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Geskin Medical LLC

  • Cardiovascular Disease Physician
  • Jefferson Hills, PA
  • NPI 1447812607
  Medicare reassignment Care Compare group NPD
• Logos Wound Care Solutions PA LLC

  • Multi-Specialty Clinic/Center
  • Cranberry TWP, PA
  • NPI 1881578987
  Medicare reassignment Care Compare group NPD
• Excela Health Physician Practices, Inc

  • Cardiovascular Disease Physician
  • Greensburg, PA
  • NPI 1821225202
  Medicare reassignment
• Renew Wound Care of Pennsylvania LLC

  • Internal Medicine Physician
  • Wyncote, PA
  • NPI 1194442640
  Medicare reassignment
• Excela Health Physician Practices, Inc.

  • Family Medicine Physician
  • Greensburg, PA
  • NPI 1235004193
  NPD
• Excela Health Physician Practices, Inc.

  • Family Medicine Physician
  • Latrobe, PA
  • NPI 1831654391
  NPD
• Allegheny Clinic Radiology

  • Diagnostic Radiology Physician
  • Pittsburgh, PA
  • NPI 1992183164
  NPD (past)
• Excela Health Physician Practices, Inc

  • Psychiatry Physician
  • Greensburg, PA
  • NPI 1861438095
  NPD (past)
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1487953527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 JEFFERSON AVE",
            "city": "JEANNETTE",
            "state": "PA",
            "postal_code": "156442538",
            "telephone_number": "724-527-8060",
            "fax_number": "724-522-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 GAMMA DR STE 210",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152382936",
            "telephone_number": "412-963-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "CARLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-15",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Russell
• Linda M Russin, D.O.
• Richard B Russman, MD
• Alexander Russo, CRNA
• Anna Christine Russo, CRNA
• John Michael Russo, LCSW
• Linda Russo
• Paige D. Russo, OTR/L
• Phillip Nicholas Russo, DDS
• Samantha Russo, CRNA

• Medical Physician Assistant in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.