MARY RUSSO DO
NPI 1023421864
Emergency Medicine in Pueblo, CO
About Mary Russo Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY RUSSO DO (NPI 1023421864) is an individual emergency medicine provider in Pueblo, Colorado, licensed in Colorado (DR.0058320) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS, maintains a secondary practice location in Kalamazoo, and is a graduate of Midwestern University, Chicago College Of Osteopathic Med (2014).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mary Russo Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Mary Russo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Pueblo, CO 81003
- Reassigned Medicare billing, Colorado enrollment
- 44 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 81003 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Russo's NPI number?
The NPI number for Mary Russo is 1023421864. It was assigned to this individual provider in the NPPES registry on June 10, 2014.
Where is Mary Russo located?
Mary Russo practices at 400 W 16th St, Pueblo, CO 81003. The listed phone number is (719) 584-4306.
What is Mary Russo's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Mary Russo enrolled in Medicare?
Yes. Mary Russo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Mary Russo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Russo reassigns Medicare benefits to Southern Colorado Emergency Medical Associates (Pueblo, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Russo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mary Russo was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mary Russo, DO · NPI 1023421864
Emergency Medicine physician in Pueblo, Colorado. Individual provider, active in the CMS NPPES registry since June 10, 2014.
## Identity
- **NPI:** 1023421864 (Entity type: Individual)
- **Enumerated:** June 10, 2014
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** DR.0058320 (Colorado)
- **Sole proprietor:** No
## Practice location
- **Address:** 400 W 16TH ST, Pueblo, CO 81003-2745
- **Phone:** (719) 584-4306 · **Fax:** (719) 595-7886
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern Colorado Emergency Medical Associates (NPI 1811793904, Pueblo, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Midwestern University, Chicago College Of Osteopathic Med, class of 2014
## Record status
- **NPPES last updated:** July 21, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1023421864) · Data from the CMS NPPES public registry.