Individual provider Active NPI

Cathy M Russo, MD

  • Anesthesiology Physician
  • Paterson, NJ
National Provider Identifier
1992790364
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA07377400 Issued in NJ
Practice address
703 Main St
St. Joseph'S Regional Medical Center
Paterson, NJ 07503-2621
Phone
(973) 754-2000
NPI assigned
Sep 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA07377400 NJ
Anesthesiology Physician 207L00000X 25MA07377400 NJ Primary
Pain Medicine Physician 208VP0000X 25MA07377400 NJ

Addresses

Primary practice location

703 Main St
St. Joseph'S Regional Medical Center
Paterson, NJ 07503-2621

Mailing address

3998 Fair Ridge Drive
Suite 300
Fairfax, VA 22033-2921
Phone (703) 295-9360

Other identifiers 3

IdentifierTypeStateIssuer
058259MedicaidNJ
0069884MedicaidNJ
P01230783OtherNJRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050803000146 NJ Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 6800824566 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07377400NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia of New Jersey LLC Anesthesiology CurrentSince May 15, 2013 Accepting new patients

Locations

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

925 Clifton Ave
Clifton, NJ 07013
Phone (908) 722-9556

630 E Palisade Ave
Englewood Cliffs, NJ 07632
Phone (201) 503-0302

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

246 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 653-3366

741 Northfield Ave
West Orange, NJ 07052
Phone (973) 243-9729

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1992790364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DRIVE",
            "address_2": "SUITE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332921",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "address_2": "ST. JOSEPH'S REGIONAL MEDICAL CENTER",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "CATHY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA07377400",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07377400",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NJ",
            "license": "25MA07377400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058259",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069884",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01230783",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.