Active NPI
Suzanne Marie Russo, RN
- Critical Care Medicine Registered Nurse
- Penn Yan, NY
National Provider Identifier
1750848446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 555826
- Practice address
- 1297 Flint Rd
Penn Yan, NY 14527-9757 - Phone
- (585) 285-0153
- NPI assigned
- Feb 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 555826 | NY | Primary |
Addresses
Primary practice location
1297 Flint Rd
Penn Yan, NY 14527-9757
Mailing address
1297 Flint Rd
Penn Yan, NY 14527-9757
Phone (585) 285-0153
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 555826 | NY | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551312000000",
"number": "1750848446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1297 FLINT RD",
"city": "PENN YAN",
"state": "NY",
"postal_code": "145279757",
"telephone_number": "585-285-0153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1297 FLINT RD",
"city": "PENN YAN",
"state": "NY",
"postal_code": "145279757",
"telephone_number": "585-285-0153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "SUZANNE",
"middle_name": "MARIE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-28",
"last_updated": "2019-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "NY",
"license": "555826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penn Yan, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.