Jack Russo, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

277526 Issued in NY

Practice address

300 Cadman PLZ W Ste 1301
Brooklyn, NY 11201-3229

Phone

(718) 208-4449

Fax

(718) 208-4663

NPI assigned

Apr 15, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, CA2 enrollments

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 2

Specialty

Otolaryngology

Education

University of California, Davis School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT and Allergy Associates LLPGroup PAC ID 0749193662, 431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101
• Mercy Medical Center Hospital, Rockville Centre, NY, CCN 330259

Merit-based Incentive Payment System (MIPS)

Final score

94.45 of 100Reported as group

Quality

89.91

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: jack.russo@direct.entandallergy.nextgenshare.com
• Direct secure messaging: jer9253@direct.nyp.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• ENT and Allergy Associates LLP

  • Otolaryngology Physician
  • Tarrytown, NY
  • NPI 1376598326
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Otolaryngology

  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Otolaryngology

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• ENT and Allergy Associates of Pennsylvania PLLC

  • Allergy & Immunology Physician
  • Willow Grove, PA
  • NPI 1548098759

  Otolaryngology

  NPD (past)

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

• Mercy Medical Center

  • Psychiatric Hospital Unit
  • Rockville Centre, NY
  • NPI 1427017854
  Care Compare affiliation
• Mercy Medical Center

  • Rehabilitation Hospital Unit
  • Rockville Centre, NY
  • NPI 1598724924
  Care Compare affiliation
• Mercy Medical Center

  • General Acute Care Hospital
  • Rockville Centre, NY
  • NPI 1659330173
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1144504044
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • Ambulance
  • New York, NY
  • NPI 1174628473

  Hospital

  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1194832477
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • Bronxville, NY
  • NPI 1780196345
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1952332801
  Care Compare affiliation

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1689990616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WHITE PLAINS RD FL 4",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915139",
            "telephone_number": "914-984-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CADMAN PLZ W STE 1301",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013229",
            "telephone_number": "718-208-4449",
            "fax_number": "718-208-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "277526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Joseph Russo
• Danielle Russo, LMSW
• Donna Russo, NP
• Filomena Russo, MS ED
• Francesca Russo
• Melissa Russo, PHARM.D.
• Nellie J Russo
• Paul Russo, MSED
• Peter Louis Russo, RPH
• Rachel T Russo

• Otolaryngology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.