Michael Russo, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

000561 Issued in CT

Practice address

400 W Main St
Branford, CT 06405-3416

Phone

(203) 483-7778

Fax

(203) 481-0234

NPI assigned

Mar 8, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 1985

Medicare assignment

May accept Medicare assignment

Group practices

Back to Health of Branford LLCGroup PAC ID 9739155045, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Back to Health of Branford, LLC

  • Internal Medicine Physician
  • Branford, CT
  • NPI 1215958772

  Chiropractor, CT

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1891762837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WEST MAIN STRRET",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053416",
            "telephone_number": "203-483-7778",
            "fax_number": "203-481-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053416",
            "telephone_number": "203-483-7778",
            "fax_number": "203-481-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "000561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "000561",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth Robins Roth, APRN
• Rubenstein Mental Health Solutions
• Eric Rubenstein, LCSW
• John Stephen Rubsam, O.D.
• Sarai Ruiz Nieves
• Peter David Russo, DMD
• Kateryna Sabanska Melillo, LMFT
• Joseph Peter Sacco, MD
• Safe Haven Psychological Services LLC
• Safe Spaces LLC

• All providers in Branford, CT
• Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.