Joseph a Russo OD, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JOSEPH A RUSSO OD, P.C.

Practice address

364 Maine Mall Rd Ste F128
South Portland, ME 04106-3206

Phone

(207) 383-3456

Fax

(207) 383-3409

NPI assigned

Apr 5, 2022

Organization subpart

No

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

Authorized official

Name

Joseph A Russo, ODNPI 1114903218

Title

Owner Optometrist

Phone

(207) 383-3456

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph A Russo, O.D.

  • Optometrist
  • South Portland, ME
  • NPI 1114903218
  NPD Authorized official

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1881335792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 MAINE MALL RD STE F128",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063206",
            "telephone_number": "207-383-3456",
            "fax_number": "207-383-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 MAINE MALL RD STE F128",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063206",
            "telephone_number": "207-383-3456",
            "fax_number": "207-383-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH A RUSSO OD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER OPTOMETRIST",
        "authorized_official_telephone_number": "207-383-3456",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meaghan Johnson
• Susan Jones, PH.D.
• Annette Jordan
• Anna H Jorgensen, MD
• Christian A Jorns, DPT
• Megan Josephs
• Josie and the Little Angels
• Stephanie L Joy, MD
• Joyful Residential Services LLC
• Clark E Judge, MD

• Optometrist in South Portland, ME
• Providers in South Portland, ME by specialty
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.