Michael G Russo MD a Professionsl LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD09346R Issued in LA

Legal business name

MICHAEL G RUSSO MD A PROFESSIONSL LLC

Practice address

1111 Medical Center Blvd
Suite S 555
Marrero, LA 70072-3151

Phone

(504) 349-6808

Fax

(504) 367-8579

NPI assigned

Jun 4, 2008

Organization subpart

No

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

Authorized official

Name

Michael G Russo, MDNPI 1194887125

Title

Physician

Phone

(504) 349-6808

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Russo, M.D.

  • Family Medicine Physician
  • Marrero, LA
  • NPI 1194887125
  Medicare reassignment NPD Authorized official
• Joann Norman, FNP

  • Family Nurse Practitioner
  • New Orleans, LA
  • NPI 1669651196
  Medicare reassignment NPD
• Denis James Lockler, MSN, APRN, ANP-C

  • Adult Health Nurse Practitioner
  • Belle Chasse, LA
  • NPI 1083617526
  NPD
• Jyotirmoy Chakraborti, M.D.

  • Nephrology Physician
  • Marrero, LA
  • NPI 1851373963
  NPD (past)
• Chakkungal P. Devidoss, M.D.

  • Nephrology Physician
  • New Orleans, LA
  • NPI 1104808302
  NPD (past)
• Trac T Le, MD

  • Nephrology Physician
  • Marrero, LA
  • NPI 1346222452
  NPD (past)
• David L Joseph, M.D.

  • Nephrology Physician
  • Tampa, FL
  • NPI 1366424129
  NPD (past)

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1710146808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE S 555",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6808",
            "fax_number": "504-367-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE S 555",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6808",
            "fax_number": "504-367-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL G RUSSO MD A PROFESSIONSL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "504-349-6808",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD09346R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1347761",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meyer Sutton, M.D., Apmc
• Erik Lee Meyers, MD
• Sierra Meyers, PHARMD
• Mga Gastrointestinal Diagnostic & Therapeutic Center (MGA Gastrointestinal Diagnostic and Therapeutic Center)
• MHM Urgent Care Westbank, LLC
• Michael Haydel MD a Medical Corporation
• Michael McSween M D L L C
• Alexis Milano
• Jessica W Miller
• Maci Miller, LCOTA

• Family Medicine Physician in Marrero, LA
• Providers in Marrero, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.