Individual provider Active NPI

Mary Bertha Russo-Colt, DO

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1790780427
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006175L Issued in PA
Practice address
3406 Peach St
Erie, PA 16508-2740
Phone
(814) 877-5381
Fax
(814) 864-3471
NPI assigned
Jun 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS006175L PA Primary

Addresses

Primary practice location

3406 Peach St
Erie, PA 16508-2740

Mailing address

3406 Peach St
Erie, PA 16508-2740
Phone (814) 877-5381

Other identifiers 1

IdentifierTypeStateIssuer
001168615OtherPAPA MEDICAID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcolt63202@upmc.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100115000260 PA Practitioner - Family Practice 8224170170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Practice addresses (Care Compare)

3406 Peach St
Erie, PA 16508-2740
Phone (814) 877-5381

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.89 of 100Reported as group
Quality
65.8
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Services Inc Family Medicine CurrentSince Apr 1, 2024 Accepting new patients

Locations

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

2 Hot Metal St
Fl 3
Pittsburgh, PA 15203
Phone (412) 432-5869

Interoperability endpoints

  • Direct secure messaging: mcolt63202@upmc.direct-ci.com

Organizations & group practices 1

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 2

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1790780427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082740",
            "telephone_number": "814-877-5381",
            "fax_number": "814-864-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082740",
            "telephone_number": "814-877-5381",
            "fax_number": "814-864-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO-COLT",
        "first_name": "MARY",
        "middle_name": "BERTHA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2026-08-25",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006175L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA MEDICAID",
            "identifier": "001168615",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcolt63202@upmc.direct-ci.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.