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ANDREA RUSSO OD
NPI 1083190854
Optometrist in San Diego, CA

Active since July 16, 2018PECOS Enrolled
3350 LA JOLLA VILLAGE DR, SAN DIEGO, CA 92161(858) 552-8585 Get Directions Write a Review

NPPES record last updated: October 24, 2019. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Oct 24, 2019, Jul 16, 2018 (2 updates tracked since 2018).

About Andrea Russo Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREA RUSSO OD (NPI 1083190854) is an individual optometrist in San Diego, California, licensed in California (34290TLG) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083190854
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameANDREA RUSSOCredential: OD
Location Address3350 LA JOLLA VILLAGE DRSan Diego, CA 92161-0002
Mailing Address4353 La Jolla Village DrSan Diego, CA 92122-1259 · (858) 622-2165
Phone(858) 552-8585
Sole ProprietorNo
Enumeration DateJuly 16, 2018
Last NPPES UpdateOctober 24, 20192 updates tracked since enumeration
✔ NPI 1083190854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in CA · 34290TLG
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
3350 LA JOLLA VILLAGE DR, San Diego, CA 92161
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrea Russo Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92161 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$140.22 typical visit price
range $62.10 – $184.71
Typical copayment $35.05 (range $15.52 – $46.17)
Most-billed visit code 99204
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. JENNIFER ANNE FREIMUND M.D.
Internal Medicine (Geriatric Medicine)
3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161
San Diego County (858) 552-7475
MRS. LINDA REID HOLLAND PT
Physical Therapist
3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161
San Diego County (858) 552-7487
DR. JONATHAN M MEYER M.D.
Psychiatry & Neurology (Psychiatry)
3350 LA JOLLA VILLAGE DR, 116-A
SAN DIEGO, CA 92161
San Diego County (858) 642-3570
ANDREW BISMARK
Psychologist (Clinical)
3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161
San Diego County (858) 245-5825
LORNA FRANCES DOUCETTE
Pharmacist (Psychiatric)
3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161
San Diego County (828) 545-5072
MS. LISA ARAI PHARM.D.
Pharmacist (Psychiatric)
3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161
San Diego County (858) 552-8585
HAYLEY MARIE HOWELLS MPT
Physical Therapist
3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161
San Diego County (858) 642-3138
JOAN MARIE FITZGERALD RN, MSN, FNP
Nurse Practitioner (Family)
3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161
San Diego County (858) 552-8585

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 Andrea Russo's NPI number?

The NPI number for Andrea Russo is 1083190854. It was assigned to this individual provider in the NPPES registry on July 16, 2018.

Where is Andrea Russo located?

Andrea Russo practices at 3350 La Jolla Village Dr, San Diego, CA 92161. The listed phone number is (858) 552-8585.

What is Andrea Russo's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Andrea Russo enrolled in Medicare?

Yes. Andrea Russo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Andrea Russo was last updated on October 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.