Active NPI
Olivia Russo
- Physical Therapist
- Palm Desert, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 75100 Mediterranean
Palm Desert, CA 92211-9069 - Phone
- (760) 837-0033
- Fax
- (760) 837-1013
- NPI assigned
- Dec 10, 2019
- Last updated
- Jun 17, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | CA | Primary |
Addresses
Primary practice location
75100 Mediterranean
Palm Desert, CA 92211-9069
Mailing address
75100 Mediterranean
Palm Desert, CA 92211-9069
Phone (760) 837-0033
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124434261 | Other | CA | EMPLOYER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
77 Medford Ave
Patchogue, NY 11772-1281
Phone (631) 758-1910
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045226 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| Easy Speech Pathology, Inc. | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Easy Speech Therapy Center | Past | Accepting new patients | |
| Nyumc Radiology Associates | Past | Accepting new patients |
Locations
1007 E Cooley Dr
Ste 107
Colton, CA 92324
Phone (760) 837-0033
41555 Cook St
Ste 100
Palm Desert, CA 92211
Phone (760) 837-0033
75100 Mediterranean
Palm Desert, CA 92211
Phone (760) 340-9832
700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325
77 Route 112
Patchogue, NY 11772
Phone (631) 207-2370
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
877 E Main St
Ste 106
Riverhead, NY 11901
Phone (631) 727-0660
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba NYU Faculty Group Practice
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NY
-
dba Easy Speech Therapy Center
- Multi-Specialty Clinic/Center
- Palm Desert, CA
- NPI 1124434261
-
dba NYU Langone Ambulatory Care Chelsea
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
- Speech-Language Pathologist
- Palm Desert, CA
- NPI 1881167237
-
- Diagnostic Radiology Physician
- New York, NY
- NPI 1962513101
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750118400000",
"number": "1558908475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75100 MEDITERRANEAN",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922119069",
"telephone_number": "760-837-0033",
"fax_number": "760-837-1013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75100 MEDITERRANEAN",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922119069",
"telephone_number": "760-837-0033",
"fax_number": "760-837-1013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "OLIVIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-10",
"last_updated": "2025-06-17",
"certification_date": "2025-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPLOYER",
"identifier": "1124434261",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.