NPIMap

Individual provider Active NPI

Gregory A. Russo, M.D.

  • Radiation Oncology Physician
  • Lebanon, NH
National Provider Identifier
1750591400
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
17279 Issued in NH
Practice address
1 Medical Center Dr
DHMC - Radiology Oncology
Lebanon, NH 03756-1000
Phone
(603) 650-6600
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 235496 MA
Radiation Oncology Physician 2085R0001X 17279 NH Primary
Radiation Oncology Physician 2085R0001X 042.0013271 VT

Addresses

Primary practice location

1 Medical Center Dr
DHMC - Radiology Oncology
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
DHMC - Radiology Oncology
Lebanon, NH 03756-1000
Phone (603) 650-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151217001955 VT Practitioner - Radiation Oncology 8123192044 Reassigns benefits to 2 organizations
I20151218001473 NH Practitioner - Radiation Oncology 8123192044 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

1080 Hospital Dr
Saint Johnsbury, VT 05819-6001
Phone (802) 257-5000

53 Fairview St
Brattleboro, VT 05301-6630
Phone (802) 257-5000

PO Box
Suite 810
Hanover, NH 03755-0810

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17279NHMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince Nov 2, 2015 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Nov 2, 2015 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Nov 2, 2015 Accepting new patients
Brattleboro Memorial Hospital PastSince Aug 1, 2016 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

53 Fairview St
Brattleboro, VT 05301
Phone (802) 251-8455

1080 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 473-4100

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/
  • Direct secure messaging: grusso202989@direct.dartmouth-hitchcock.org

Organizations & group practices 4

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1750591400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC - RADIOLOGY ONCOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC - RADIOLOGY ONCOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "GREGORY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MA",
            "license": "235496",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NH",
            "license": "17279",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "VT",
            "license": "042.0013271",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.