Randi Ruth Larussa, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001164 Issued in NY

Practice address

435 E Henrietta Rd
Rochester, NY 14620-4629

Phone

(585) 760-5466

Fax

(585) 760-5467

NPI assigned

Oct 24, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1699858258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ST CAMILLUS WAY",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "14450",
            "telephone_number": "585-377-4000",
            "fax_number": "585-377-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 E HENRIETTA RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204629",
            "telephone_number": "585-760-5466",
            "fax_number": "585-760-5467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUSSA",
        "first_name": "RANDI",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "001164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lars-Goran Larsson, MD
• Elizabeth Larue, RD
• Mary K Larue, RN
• Heather Laruez
• Lawrence Larussa, PA
• Marie Ayorkor Laryea, MD.CM
• Ellen Larzelere
• Lisa Lasalle, PA-C
• Megan Callanan Lasaponara, MD
• Agnes Olufunke Laseinde, MD

• Physician Assistant in Rochester, NY
• Providers in Rochester, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.