DR. SAMUEL J. RUSSO (NPI# 1962510636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962510636 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL J. RUSSO |
| Credential | DO |
| Practice Address |
2572 N Us Highway 131 Elmira MI 49730-8252 |
| Mailing Address |
829 N Center Ave Suite 298 Gaylord MI 49735-1595 |
| Practice Telephone | 9897317700 |
| Practice Fax Number | 9897312999 |
| Mailing Telephone | 9897317708 |
| Mailing Fax Number | 9897317929 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2013-12-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101008981 | MI | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | DO15969 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500400122 | 05 | |
| GROUP MEDICARE ID | OF96004 | 01 |
| Street Address |
2572 N US HIGHWAY 131 |
| City | ELMIRA |
| State | MI |
| Zip Code | 49730-8252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306202023 | Emily E. Martinez | Physician Assistant | 2572 N Us Highway 131, Elmira, MI 49730-8252 | 2016-01-11 |
| 1992146807 | Munson Healthcare Otsego Memorial Hospital | General Practice | 2572 N Us Highway 131, Elmira, MI 49730 | 2013-07-09 |
| 1265871339 | Munson Healthcare Otsego Memorial Hospital | General Practice | 2572 N Us Highway 131, Elmira, MI 49730 | 2013-06-21 |
| 1831345263 | Marcella Hill | Physician Assistant | 2572 N Us Highway 131, Elmira, MI 49730-8252 | 2008-08-18 |
| 1811155112 | Nathan Andrew Mann | Family Medicine | 2572 N Us Highway 131, Elmira, MI 49730-8252 | 2008-05-23 |
| 1326105818 | Teresa Bearss Kersting | Physician Assistant | 2572 N Us Highway 131, Elmira, MI 49730 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659970671 | April A Kelly | Licensed Practical Nurse | 830 Larchmont Rd, Elmira, NY 14905-1249 | 2020-10-21 |
| 1912506007 | Niki Bradway | Licensed Practical Nurse | 1011 Oak St, Elmira, NY 14901-1600 | 2020-10-20 |
| 1841899838 | Tosha Leann Brooks | Licensed Practical Nurse | 322 Grant St, Elmira, NY 14901-1321 | 2020-10-20 |
| 1235745282 | April Lynne Mott | Nurse Practitioner | 600 Ivy St Ste 108, Elmira, NY 14905-1627 | 2020-09-16 |
| 1497365977 | Lavora Dawn Bradley | Voluntary or Charitable | 1305 Maple Ave, Elmira, NY 14904-3045 | 2020-08-09 |
| 1518580851 | Schuyler County Chapter, Nysarc, Inc. | Intermediate Care Facility, Mentally Retarded | 525 Liberty St, Elmira, NY 14904-1517 | 2020-05-21 |
| 1306467287 | Justin Alvarez Holmes | Student in an Organized Health Care Education/Training Program | 200 Madison Ave Ste 2e, Elmira, NY 14901-3219 | 2020-05-01 |
| 1720609894 | Jillian Brenna Perrault | Specialist/Technologist | 16 Abbey Rd, Elmira, NY 14905-1735 | 2020-04-30 |
| 1952932170 | Jennifer A Whitt | Registered Nurse | 1714 Lovell Ter, Elmira, NY 14905-1235 | 2020-01-27 |
| 1326688987 | Susan Sterpe | Licensed Practical Nurse | 505 W Washington Ave, Elmira, NY 14901-1910 | 2020-01-13 |
| Find all providers in ELMIRA | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356886683 | Water Street West Integrative Medicine, Pllc | Family Medicine | 244 W Water St, Suite 104, Elmira, NY 14901-2926 | 2016-12-22 |
| 1770922460 | Pamela Joy Cary | Family Medicine | 89935 Territorial Rd, Elmira, OR 97437-9747 | 2013-06-17 |
| 1740628791 | Heather Nicole Underhill | Family Medicine | 571 Saint Josephs Blvd Fl 2, Elmira, NY 14901-3230 | 2013-06-12 |
| 1497906952 | Looknarine Persaud | Family Medicine | 521 Larchmont Rd, Elmira, NY 14905-1214 | 2008-10-02 |
| 1578624078 | Nutrition Clinic | Family Medicine | 1003 Walnut Street, Elmira, NY 14901 | 2006-12-12 |
| 1427168004 | Anthony F Oliva | Family Medicine | 409 Foster Ave, Elmira, NY 14905-2229 | 2006-08-30 |
| 1669440707 | Brent S. Ingerick | Family Medicine | 1336 Cedar St, Elmira, NY 14904-2951 | 2006-03-14 |
| 1497275242 | Esra Salah Shermadou | Family Medicine | 200 Madison Ave, Elmira, NY 14901 | 2017-06-22 |
| 1639529514 | Lukas Mathews | Family Medicine | 555 Saint Josephs Blvd, Elmira, NY 14901-3223 | 2016-06-21 |
| 1598129868 | Kenneth Onuorah | Family Medicine | 602 Ivy St, Elmira, NY 14905-1646 | 2016-04-12 |
| Find all providers in ELMIRA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.