Active NPI
David P Russo, MD
- Internal Medicine Physician
- Windsor, VT
National Provider Identifier
1922094291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 042-0009438
- Practice address
- 289 County Rd
Windsor, VT 05089-9000 - Phone
- (802) 674-7300
- Fax
- (802) 674-7314
- NPI assigned
- Sep 22, 2005
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 042-0009438 | VT | Primary |
Addresses
Primary practice location
289 County Rd
Windsor, VT 05089-9000
Mailing address
289 County Rd
Windsor, VT 05089-9000
Phone (802) 674-7300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004047 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.17 of 100
- Quality
- 84.29
- Promoting interoperability
- 96
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0009438 | VT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Regional Hospital Inc. | Internal Medicine | Current | Accepting new patients |
Locations
243 Elm St
Claremont, NH 03743
Phone (603) 542-7771
Interoperability endpoints
- vrhdrusso@yourcarecommunity.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Valley Regional Primary Care Physicians
- Family Medicine Physician
- Newport, NH
- NPI 1366687683
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922094291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "289 COUNTY RD",
"city": "WINDSOR",
"state": "VT",
"postal_code": "050899000",
"telephone_number": "802-674-7300",
"fax_number": "802-674-7314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "289 COUNTY RD",
"city": "WINDSOR",
"state": "VT",
"postal_code": "050899000",
"telephone_number": "802-674-7300",
"fax_number": "802-674-7314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "DAVID",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VT",
"license": "042-0009438",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0004047",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Windsor, VT
Sources for this page
- 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.