Michael S. Russo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00991200 Issued in NJ

Practice address

10 Church Towers
Hoboken, NJ 07030

Phone

(201) 401-9687

NPI assigned

Jan 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Hoboken Physical Therapy and Wellness Center

  • Physical Therapy Clinic/Center
  • Hoboken, NJ
  • NPI 1356312615

  Physical Therapist

  NPD (past) Authorized official
• Physical Therapy Center Management Group, LLC

  • Physical Therapist
  • Carteret, NJ
  • NPI 1104840552
  NPD (past) Authorized official

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1619948973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023054",
            "telephone_number": "201-339-1109",
            "fax_number": "908-353-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CHURCH TOWERS",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "07030",
            "telephone_number": "201-401-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00991200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1619948973",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hayley Elizabeth Ruff
• Lauren Ruffrage, M.S.
• Meredith L Ruggiero, M.S. OT
• Vicente Z Ruiz, MD
• Annie L Russo, LCSW, LCADC
• Yusef Hassan Sabri Hamid, MD
• George Safran, M.D.
• Feras Saifan
• Suruchi Saini
• Saint Luke'S Roosevelt Hospital

• All providers in Hoboken, NJ
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.