Individual provider Active NPI

Aidan Russo, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Livingston, NJ
National Provider Identifier
1689259772
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
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

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210421000085 NY Practitioner - Physician Assistant 2365850971 Reassigns benefits to 1 organization

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
Bobby Buka, M.D., P.C.Group PAC ID 0547351140, 140 clinicians

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

OrganizationSpecialtyStatusNew patients
Bobby Buka, M.D., P.C. CurrentSince Apr 12, 2021 Accepting new patients
Mount Sinai Hospital Past Accepting new patients
Atlas Infectious Disease Practice PLLC Past Accepting new patients
Out East Medical PastSince Jun 15, 2021 Accepting new patients
Derm Specs of PA PLLC PastSince Feb 25, 2024 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

  • FHIR API: https://api.platform.athenahealth.com/22363/brand/1/csg/1/fhir/r4
  • FHIR API: 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.

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

Verify at the official NPI Registry.