Active NPI
Aidan Russo, PHYSICIAN ASSISTANT
- Medical Physician Assistant
- Livingston, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 15 Longview Rd
Livingston, NJ 07039-3621 - Phone
- (973) 650-1063
- NPI assigned
- Mar 10, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
15 Longview Rd
Livingston, NJ 07039-3621
Mailing address
15 Longview Rd
Livingston, NJ 07039-3621
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1163 Myrtle Ave
Brooklyn, NY 11206-6007
Phone (212) 385-3700
152 Broadway
Brooklyn, NY 11211-8767
Phone (212) 385-3700
220 Front St
New York, NY 10038-2033
Phone (212) 385-3700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bobby Buka, M.D., P.C. | Current | Accepting new patients | |
| Mount Sinai Hospital | Past | Accepting new patients | |
| Atlas Infectious Disease Practice PLLC | Past | Accepting new patients | |
| Out East Medical | Past | Accepting new patients | |
| Derm Specs of PA PLLC | Past | Accepting new patients |
Locations
3179 Steinway St
Astoria, NY 11103
1163 Myrtle Ave
Brooklyn, NY 11206
1027 46th Ave
Fl 1
Long Island City, NY 11101
214 Sullivan St
New York, NY 10012
2121 Adam Clayton Powell Jr Blvd
New York, NY 10027
Phone (718) 534-8190
1425 2nd Ave
New York, NY 10021
625 10th Ave
New York, NY 10036
3531 Long Beach Rd
Oceanside, NY 11572
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Interoperability endpoints
- https://api.platform.athenahealth.com/22363/brand/1/csg/1/fhir/r4
- https://fhir4.healow.com/fhir/r4/BFCDAA
Organizations & group practices 5
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.
-
- Dermatology Physician
- New York, NY
- NPI 1134349954
-
- Infectious Disease Physician
- Atlantis, FL
- NPI 1326655846
-
- Dermatology Physician
- Philadelphia, PA
- NPI 1528823507
-
- General Acute Care Hospital
- New York, NY
- NPI 1932103413
-
- Dermatology Physician
- Oceanside, NY
- NPI 1730757311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1689259772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 LONGVIEW RD",
"city": "LIVINGSTON",
"state": "NJ",
"postal_code": "070393621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 LONGVIEW RD",
"city": "LIVINGSTON",
"state": "NJ",
"postal_code": "070393621",
"telephone_number": "973-650-1063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "AIDAN",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-10",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Livingston, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.