Individual provider Active NPI

David Scott Russo

  • Orthopedic Physical Therapist
  • Palm Harbor, FL
National Provider Identifier
1740340876
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT 21117 Issued in FL
Practice address
37026 US Highway 19 N
Palm Harbor, FL 34684-1109
Phone
(727) 938-1935
NPI assigned
Dec 11, 2006
Last updated
Feb 24, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT 21117 FL Primary

Addresses

Primary practice location

37026 US Highway 19 N
Palm Harbor, FL 34684-1109

Mailing address

37026 US Highway 19 N
#330B
Palm Harbor, FL 34684-1109
Phone (727) 938-1935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120620000796 FL Practitioner - Physical Therapist in Private Practice 6305000423 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ewing and Thomas, IncGroup PAC ID 2668382052, 6 clinicians

Practice addresses (Care Compare)

5311 Grand Blvd
New Port Richey, FL 34652-4014
Phone (727) 848-3962

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 21117FLMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Farhan Siddiqi, MD PA CurrentSince Jun 5, 2021 Accepting new patients
Ewing and Thomas, Inc. Orthopedic CurrentSince Jun 5, 2021 Accepting new patients
Sobe Innovative Rehabilitation PLLC Orthopedic CurrentSince Mar 8, 2025 Accepting new patients
Jeffery J. Kromolicki PA CurrentSince Feb 2, 2019 Accepting new patients
Farhan Siddiqi, MD PA CurrentSince Jun 5, 2021 Accepting new patients
Ewing and Thomas, Inc CurrentSince Jun 5, 2021 Accepting new patients

Locations

2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014

11329 Cortez Blvd
Brooksville, FL 34613
Phone (352) 340-5935

5311 Grand Blvd
New Prt Rchy, FL 34652
Phone (727) 848-3962

2040 Short Ave
Odessa, FL 33556
Phone (727) 372-9922

11319 Cortez Blvd
Spring Hill, FL 34613
Phone (352) 556-2524

701 N West Shore Blvd
Tampa, FL 33609
Phone (352) 340-5935

2019 Little Rd
Trinity, FL 34655
Phone (727) 375-7557

7005 Nightwalker Rd
Weeki Wachee, FL 34613
Phone (352) 556-2524

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1740340876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37026 US HIGHWAY 19 N",
            "address_2": "#330B",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841109",
            "telephone_number": "727-938-1935",
            "fax_number": "727-937-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37026 US HIGHWAY 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841109",
            "telephone_number": "727-938-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT 21117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.