Jessica Dean Russo, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS015317 Issued in PA

Practice address

230 S. Broad St.
Ste 600
Phila, PA 19102-4121

Phone

(215) 545-2748

Fax

(215) 545-2749

NPI assigned

Mar 6, 2007

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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.

• Adrian Chiu, PH.D., PLLC

  • Psychologist
  • Ambler, PA
  • NPI 1366890337
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1659401990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 S. BROAD ST.",
            "address_2": "STE 600",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191024121",
            "telephone_number": "215-545-2748",
            "fax_number": "215-545-2749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S. BROAD ST.",
            "address_2": "STE 600",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191024121",
            "telephone_number": "215-545-2748",
            "fax_number": "215-545-2749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JESSICA",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS015317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "1522333",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1522333",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sameerah D Rowland
• Royal Drugs
• Emily Rubin, R.D.
• Jack Rubinlicht, DPM
• Richard Lee Rush, DDS
• Eileen Ryan, CRNP
• Tierra Toni Ryan, PHARM.D
• S.G. Isaacs Enterprises, Inc.
• Polly Sacco Ezzell, RN
• Duri Sabina Saeed

• Clinical Psychologist in Phila, PA
• Providers in Phila, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.
• 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.

Verify at the official NPI Registry.