DR. RANDOLPH JOSEPH RUSSO DC
NPI 1073697637
Chiropractor in New City, NY
About Dr. Randolph Joseph Russo Dc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. RANDOLPH JOSEPH RUSSO DC (NPI 1073697637) is an individual chiropractor in New City, New York, licensed in New York (X008265-1) and active in the NPI registry since October 2006.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Randolph Joseph Russo Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Randolph Russo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Stony Point, NY 10980
- Reassigned Medicare billing, New York enrollment
- 26 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.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW CITY, NY 10956
NEW CITY, NY 10956
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 Randolph Russo's NPI number?
The NPI number for Randolph Russo is 1073697637. It was assigned to this individual provider in the NPPES registry on October 24, 2006.
Where is Randolph Russo located?
Randolph Russo practices at 16 Squadron Blvd Ste 102, New City, NY 10956. The listed phone number is (845) 634-2225.
What is Randolph Russo's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Randolph Russo enrolled in Medicare?
Yes. Randolph Russo is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Randolph Russo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Randolph Russo reassigns Medicare benefits to Kayal Orthopaedic, PLLC (Stony Point, NY). 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 Randolph 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 Randolph Russo was last updated on April 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Dr. Randolph Joseph Russo, DC · NPI 1073697637
Chiropractor provider in New City, New York. Individual provider, active in the CMS NPPES registry since October 24, 2006.
## Identity
- **NPI:** 1073697637 (Entity type: Individual)
- **Enumerated:** October 24, 2006
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **State license:** X008265-1 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 16 SQUADRON BLVD, STE 102, New City, NY 10956-5268
- **Phone:** (845) 634-2225 · **Fax:** (845) 634-2227
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Kayal Orthopaedic, PLLC (NPI 1164164455, Stony Point, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 25, 2023
---
Source: [NPI Profile](https://npiprofile.com/npi/1073697637) · Data from the CMS NPPES public registry.