Active NPI
Matthew William Russo, M.D.
- Orthopaedic Surgery Physician
- Scottsdale, AZ
National Provider Identifier
1710277744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 52287
- Practice address
- 8405 N Pima Center Pkwy Ste 101
Scottsdale, AZ 85258-4669 - Phone
- (602) 385-2115
- Fax
- (602) 772-3801
- NPI assigned
- Apr 11, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 0101260365 | VA | |
| Orthopaedic Surgery Physician | 207X00000X | D0081329 | MD | |
| Orthopaedic Surgery Physician | 207X00000X | 52287 | AZ | Primary |
Addresses
Primary practice location
8405 N Pima Center Pkwy Ste 101
Scottsdale, AZ 85258-4669
Mailing address
PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0081329 | MD | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic Specialists of North America, PLLC | Orthopaedic Surgery | Past | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Phoenix, AZ
- NPI 1770812828
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658793600000",
"number": "1710277744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 80217",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850600217",
"telephone_number": "602-385-2115",
"fax_number": "480-418-3323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8405 N PIMA CENTER PKWY STE 101",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852584669",
"telephone_number": "602-385-2115",
"fax_number": "602-772-3801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "MATTHEW",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-11",
"last_updated": "2022-07-26",
"certification_date": "2022-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "VA",
"license": "0101260365",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MD",
"license": "D0081329",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "AZ",
"license": "52287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.