Individual provider Active NPI

Joseph Bruno Larussa, M.D.

  • Specialist
  • Birmingham, AL
National Provider Identifier
1588762165
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
00016064 Issued in AL
Practice address
2908 Central Ave
Suite 100
Birmingham, AL 35209-2506
Phone
(205) 933-5599
Fax
(205) 930-2611
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 00016064 AL Primary

Addresses

Primary practice location

2908 Central Ave
Suite 100
Birmingham, AL 35209-2506

Mailing address

2908 Central Ave
Suite 100
Birmingham, AL 35209-2506
Phone (205) 933-5599

Other identifiers 1

IdentifierTypeStateIssuer
51039854OtherALBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20091216000351 AL Practitioner - Allergy/Immunology 0143360586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Alabama School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2908 Central Ave
Suite 100
Homewood, AL 35209-2578
Phone (205) 933-5599

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00016064ALMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric & Adult Asthma and Allergy, P.C Specialist CurrentSince Feb 11, 1998 Accepting new patients

Locations

2908 Central Ave
Ste 100
Homewood, AL 35209
Phone (205) 933-5599

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1588762165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 CENTRAL AVE",
            "address_2": "SUITE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352092506",
            "telephone_number": "205-933-5599",
            "fax_number": "205-930-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 CENTRAL AVE",
            "address_2": "SUITE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352092506",
            "telephone_number": "205-933-5599",
            "fax_number": "205-930-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUSSA",
        "first_name": "JOSEPH",
        "middle_name": "BRUNO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "00016064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51039854",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.