Active NPI
Penni M Russo-Going, MD
- Family Medicine Physician
- Miramar, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- M0549
- Practice address
- 3601 SW 160TH Ave
Suite #250
Miramar, FL 33027-6308 - Phone
- (305) 866-9951
- NPI assigned
- Nov 17, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Trauma Surgery Physician | 2086S0127X | M0549 | TX | |
| Surgery Physician | 208600000X | M0549 | TX | |
| Family Medicine Physician | 207Q00000X | M0549 | TX | Primary |
Addresses
Primary practice location
3601 SW 160TH Ave
Suite #250
Miramar, FL 33027-6308
Mailing address
1631 North Loop W
Suite #220
Houston, TX 77008-1528
Phone (713) 426-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1749160-01 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Texas Medical School at Houston, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11621A Katy Fwy
Houston, TX 77079-1801
Phone (832) 399-5300
12345 Katy Fwy
Houston, TX 77079-1503
Phone (281) 679-5600
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M0549 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Current Care PA | Current | Accepting new patients | |
| American Current Care, P.a. | Current | Accepting new patients | |
| American Current Care P.a. | Current | Accepting new patients |
Locations
15810 Midway Rd
Addison, TX 75001
Phone (972) 458-8111
5080 Spectrum Dr
Ste 1200W
Addison, TX 75001
4025 Spid Dr
Corpus Christi, TX 78411
Phone (361) 852-8255
1002 Abc Ave
Ste 600
Freeport, TX 77541
Phone (979) 233-6571
12345 Katy Fwy
Houston, TX 77079
Phone (281) 679-5600
Organizations & group practices 3
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.
-
- Health Service Clinic/Center
- Addison, TX
- NPI 1275651002
-
dba Concentra Urgent Care
- Urgent Care Clinic/Center
- Beaumont, TX
- NPI 1376356568
-
dba Concentra Urgent Care
- Urgent Care Clinic/Center
- Freeport, TX
- NPI 1942790662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301616000000",
"number": "1942282652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 NORTH LOOP W",
"address_2": "SUITE #220",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770081528",
"telephone_number": "713-426-2400",
"fax_number": "713-426-3204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 SW 160TH AVE",
"address_2": "SUITE #250",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330276308",
"telephone_number": "305-866-9951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO-GOING",
"first_name": "PENNI",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-17",
"last_updated": "2011-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "TX",
"license": "M0549",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "M0549",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "M0549",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1749160-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; 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.