Fred Cipriano Russo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R023424 Issued in NY

Practice address

1023 Pulaski Road
East Northport, NY 11731

Phone

(631) 261-4296

Fax

(631) 261-4296

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821144288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 PULASKI ROAD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "11731",
            "telephone_number": "631-261-4296",
            "fax_number": "631-261-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 PULASKI ROAD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "11731",
            "telephone_number": "631-261-4296",
            "fax_number": "631-261-4296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "FRED",
        "middle_name": "CIPRIANO",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R023424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01968423",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "118060",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7400383",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Lynn Romano, M.S., L.AC.
• Yaacov J. Rose, PH.D.
• Barry Rosen, LCSW
• Gion Franco Rossi, P. T.
• Sharon A. Rubinstein, SLP
• Anthony R Ruvo, M.D.
• RX Express Prescription Service Inc
• Lindsay Ryan, FNP
• Marta M Saenz, RPH
• Kimberly Sanfilippo

• Clinical Social Worker in East Northport, NY
• Providers in East Northport, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• 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.