Paula Petrullo Russo, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

00382 Issued in WV

Practice address

207 E 5TH Ave
Ranson, WV 25438-1613

Phone

(304) 728-5051

Fax

(304) 728-9735

NPI assigned

Jan 26, 2007

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 WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Robert E Jones III, MD

  • Internal Medicine Physician
  • Ranson, WV
  • NPI 1255331021
  Medicare reassignment
• Robert Jones MD

  • Adolescent Medicine (Internal Medicine) Physician
  • Ranson, WV
  • NPI 1932269024
  NPD
• Walnut Street Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hagerstown, MD
  • NPI 1366425266
  NPD (past)

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619023322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6568 FLOWING SPRINGS RD",
            "city": "SHENANDOAH JUNCTION",
            "state": "WV",
            "postal_code": "254424666",
            "telephone_number": "304-876-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E 5TH AVE",
            "city": "RANSON",
            "state": "WV",
            "postal_code": "254381613",
            "telephone_number": "304-728-5051",
            "fax_number": "304-728-9735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "PAULA",
        "middle_name": "PETRULLO",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "00382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebuck & Associates Eye Care PLLC
• Richard Carl Rebuck, OD
• Caitlyn Hannah Regalia, CPHT
• Carrie Renee Riston
• Robert Jones MD
• Skylar Rose Sade, PA
• Said H Sana, MD
• Shelby Louise Sanchez Marquez
• Chelsey Lynn Savinsky, PHARMD
• Nathan C Schaffer, DPT, PT

• Medical Physician Assistant in Ranson, WV
• Providers in Ranson, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.