Krista Russo, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

53036 Issued in CA

Practice address

41715 Winchester Rd
101
Temecula, CA 92590-4808

Phone

(951) 308-4451

NPI assigned

Nov 9, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krusso313255@direct.ochin.org

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.

• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • San Marcos, CA
  • NPI 1245246917
  Medicare reassignment
• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • Carlsbad, CA
  • NPI 1255347704
  NPD
• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • San Marcos, CA
  • NPI 1588489975
  NPD

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1922471192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41715 WINCHESTER RD",
            "address_2": "101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925904808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41715 WINCHESTER RD",
            "address_2": "101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925904808",
            "telephone_number": "951-308-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "KRISTA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-09",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "53036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie Russell
• Nicola Michelle Russell, RN
• Sarah Russell, M.D
• Brianna Aleaha Russette
• Lynn Russikoff
• Leah Rene Russo
• Cynthia Kathleen Ruth
• John Ruzzamenti, D.D.S.
• RW Fattouch DMD, Inc.
• Ryan Borland Marriage and Family Therapy Inc.

• Medical Physician Assistant in Temecula, CA
• Providers in Temecula, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.