Active NPI
Nicholas John Russo, M.D
- Vascular Surgery Physician
- Neptune City, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 25MA11351700
- Practice address
- 19 Davis Ave FL 4
Neptune City, NJ 07753-4488 - Phone
- (732) 212-6598
- NPI assigned
- Mar 29, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NY | ||
| Vascular Surgery Physician | 2086S0129X | 25MA11351700 | NJ | Primary |
Addresses
Primary practice location
19 Davis Ave FL 4
Neptune City, NJ 07753-4488
Mailing address
19 Davis Ave FL 4
Neptune City, NJ 07753-4488
Phone (732) 212-6598
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Riverview PLZ
Red Bank, NJ 07701-1864
Phone (732) 264-1132
1140 Route 72 W
Manahawkin, NJ 08050-2412
Phone (609) 597-6011
19 Davis Ave
Neptune, NJ 07753-4488
1944 Route 33
Neptune, NJ 07753
Phone (732) 776-3787
1945 Route 33
Neptune, NJ 07753
30 Prospect Ave
Hackensack, NJ 07601-1915
3600 Route 66
FL 3
Neptune, NJ 07753
727 N Beers St
Holmdel, NJ 07733-1514
Phone (732) 714-2700
Hospital & facility affiliations
- Jersey Shore University Medical Center
- Bayshore Medical Center
- Southern Ocean Medical Center
- Riverview Medical Center
- Ocean Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.33 of 100
- Quality
- 66.38
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.39
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 14 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA11351700 | NJ | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current | Accepting new patients | |
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current | Accepting new patients |
Locations
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787
3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463
1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204
425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IHJHBD
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 and National Provider Directory roles.
-
- Surgical Critical Care Physician
- Red Bank, NJ
- NPI 1215989249
-
- Durable Medical Equipment & Medical Supplies
- North Bergen, NJ
- NPI 1215734199
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brick, NJ
- NPI 1477065126
-
- General Acute Care Hospital
- Red Bank, NJ
- NPI 1710499462
-
- General Acute Care Hospital
- Holmdel, NJ
- NPI 1760994412
-
- General Acute Care Hospital
- Neptune, NJ
- NPI 1790297547
-
- General Acute Care Hospital
- Manahawkin, NJ
- NPI 1831601590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753660800000",
"number": "1679005649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 DAVIS AVE FL 4",
"city": "NEPTUNE CITY",
"state": "NJ",
"postal_code": "077534488",
"telephone_number": "732-212-6598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 DAVIS AVE FL 4",
"city": "NEPTUNE CITY",
"state": "NJ",
"postal_code": "077534488",
"telephone_number": "732-212-6598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "NICHOLAS",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-29",
"last_updated": "2025-07-28",
"certification_date": "2025-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": null,
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "NJ",
"license": "25MA11351700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Neptune City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.