Individual provider Active NPI

Joie Russo, M.D.

  • Obstetrics Physician
  • Encino, CA
National Provider Identifier
1619988532
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
20A8335 Issued in CA
Practice address
18034 Ventura Blvd Ste 332
Encino, CA 91316-3516
Phone
(818) 757-2345
Fax
(818) 757-0137
NPI assigned
Aug 10, 2006
Last updated
May 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 20A8335 CA Primary

Addresses

Primary practice location

18034 Ventura Blvd Ste 332
Encino, CA 91316-3516

Mailing address

18034 Ventura Blvd Ste 332
Encino, CA 91316-3516
Phone (818) 757-2345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040914001236 CA Practitioner - Obstetrics/Gynecology 3870568330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

18370 Burbank Blvd
Suite 601
Tarzana, CA 91356-2831
Phone (818) 757-2345

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Group Inc Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1619988532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18034 VENTURA BLVD STE 332",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163516",
            "telephone_number": "818-757-2345",
            "fax_number": "818-757-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18034 VENTURA BLVD STE 332",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163516",
            "telephone_number": "818-757-2345",
            "fax_number": "818-757-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JOIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CA",
            "license": "20A8335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.