Patrick J Russo Jr., MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

200301049 Issued in NC

Practice address

2555 Court Dr
Suite 300
Gastonia, NC 28054-2134

Phone

(704) 868-3256

Fax

(704) 868-5870

NPI assigned

Jul 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Creighton University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032
• Atrium Health Cleveland Hospital, Shelby, NC, CCN 340021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272
  Medicare reassignment Care Compare group NPD
• Caromont Medical Group Inc

  • Vascular Surgery Physician
  • Gastonia, NC
  • NPI 1790010890
  NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1245419845
  NPD (past)
• Greater Philadelphia Cardiology Assc Inc

  • Specialist
  • Philadelphia, PA
  • NPI 1568516243
  NPD (past)
• Medcath Partners, LLC

  • Radiology Clinic/Center
  • Philadelphia, PA
  • NPI 1508821158
  NPD (past)

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

• Atrium Health Hospitals Inc

  • General Acute Care Hospital
  • Shelby, NC
  • NPI 1669348991
  Care Compare affiliation
• Gaston Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Gastonia, NC
  • NPI 1013918960
  Care Compare affiliation

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1861490195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 COURT DR",
            "address_2": "SUITE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542134",
            "telephone_number": "704-868-3256",
            "fax_number": "704-868-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COURT DR",
            "address_2": "SUITE 300",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542134",
            "telephone_number": "704-868-3256",
            "fax_number": "704-868-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "26794",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NC",
            "license": "200301049",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "SC",
            "license": "26794",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "200301049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891345R",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N01046",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Wilson Rummage, DNP
• Mallika Rupani, DDS
• Beverly Rushing, LPC
• Lainie Russell
• Marquita Russell, LCSW-A
• Mystique Shavonne Rutledge
• Samantha Ann Ryan
• S & C Home Care, LLC
• Heydy Saavedra
• Mauricio Sabogal, D.O.

• Cardiovascular Disease Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; 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.