Individual provider Active NPI

Cara Lynn Russo, N.P.

  • Family Nurse Practitioner
  • Lynn, MA
National Provider Identifier
1558799494
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2277205 Issued in MA
Practice address
50 Boston St
Lynn, MA 01904-2538
Phone
(781) 342-4191
Fax
(833) 450-5157
NPI assigned
Oct 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 522839 MA
Family Nurse Practitioner 363LF0000X RN2277205 MA Primary

Addresses

Primary practice location

50 Boston St
Lynn, MA 01904-2538

Mailing address

780 Albany St
Boston, MA 02118-2755
Phone (857) 654-1000

Other practice location 1

780 Albany St
Boston, MA 02118-2755
Phone (857) 654-1000

Other practice location 2

205 Parkingway
Quincy, MA 02169-0216
Phone (617) 820-5968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20250804002881 MA Order and Referring Only - Nurse Practitioner 7012130560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
522839MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Hospital Inc PastSince Apr 1, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: crusso351316@direct.ochin.org
  • Direct secure messaging: cara.russo.1@27127.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1558799494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182755",
            "telephone_number": "857-654-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BOSTON ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019042538",
            "telephone_number": "781-342-4191",
            "fax_number": "833-450-5157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 Albany St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182755",
            "country_code": "US",
            "telephone_number": "857-654-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 Parkingway",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "021690216",
            "country_code": "US",
            "telephone_number": "617-820-5968",
            "fax_number": "833-471-5603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "CARA",
        "middle_name": "LYNN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "522839",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2277205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.