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DR. NICHOLAS ANTHONY RUSSO MD
NPI 1174151930
Family Medicine in New York, NY

Active since March 29, 2020PECOS Enrolled
185 BROADWAY FL 2, NEW YORK, NY 10007(415) 658-6791(415) 252-7176 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 14, 2025, Apr 16, 2020, Mar 29, 2020 (3 updates tracked since 2020).

About Dr. Nicholas Anthony Russo Md NPPES

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

DR. NICHOLAS ANTHONY RUSSO MD (NPI 1174151930) is an individual family medicine provider in New York, New York, licensed in New York (333488) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS and maintains a secondary practice location in Hackensack.

NPPES Registry Identity

NPI1174151930
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. NICHOLAS ANTHONY RUSSOCredential: MD
Location Address185 BROADWAY FL 2New York, NY 10007-0167
Mailing Address1 Embarcadero Ctr Ste 1900San Francisco, CA 94111-3723
Phone(415) 658-6791
Fax(415) 252-7176
Sole ProprietorNo
Enumeration DateMarch 29, 2020
Last NPPES UpdateMarch 14, 20253 updates tracked since enumeration
NPPES CertifiedMarch 14, 2025
✔ NPI 1174151930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 333488
Definition
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
185 BROADWAY FL 2, New York, NY 10007
Open in Google Maps ↗

Secondary Practice Location 1

Location 130 Prospect AveHackensack, NJ 07601-1915 · Phone (551) 996-2000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicholas Anthony Russo Md 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.

Medicare Billing Reassignment

Medicare enrollment records show Nicholas Russo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mount Sinai School Of Medicine
4.2 mi
Family Medicine
1790 BROADWAY STE 1802
New York, NY 10019
  • Reassigned Medicare billing, New York enrollment
  • 99 clinicians in this Medicare group
NPI 1528538774 (212) 530-0624

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10007 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
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
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 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WHITNEY DANNELLE DAVIDSON MSN, FNP-BC
Nurse Practitioner (Primary Care)
185 BROADWAY FL 2
NEW YORK, NY 10007
New York County (888) 663-6331
MR. CORY GERMAN PA-S
Physician Assistant (Medical)
185 BROADWAY FL 2
NEW YORK, NY 10007
New York County (888) 663-6331
SAMUEL UZOSIKE MD
Family Medicine
185 BROADWAY FL 2
NEW YORK, NY 10007
New York County (888) 663-6331
DR. AZAD JOHN-SALIMI M.D.
Family Medicine
185 BROADWAY FL 2
NEW YORK, NY 10007
New York County (888) 663-6331
RAY RYAN MIN DO
Family Medicine
185 BROADWAY FL 2
NEW YORK, NY 10007
New York County (888) 663-6331
DR. HAO LAM D.O.
Family Medicine
185 BROADWAY FL 2
NEW YORK, NY 10007
New York County (888) 663-6331
SUZANNAH CAPINEA DINSMORE
Nurse Practitioner
185 BROADWAY FL 2
NEW YORK, NY 10007
New York County (888) 663-6331
ALEXANDRA PAULINE BERWICK
Physician Assistant
185 BROADWAY FL 2
NEW YORK, NY 10007
New York County (415) 658-6791

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 Nicholas Russo's NPI number?

The NPI number for Nicholas Russo is 1174151930. It was assigned to this individual provider in the NPPES registry on March 29, 2020.

Where is Nicholas Russo located?

Nicholas Russo practices at 185 Broadway Fl 2, New York, NY 10007. The listed phone number is (415) 658-6791.

What is Nicholas Russo's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Nicholas Russo enrolled in Medicare?

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

Which organization bills Medicare for Nicholas Russo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicholas Russo reassigns Medicare benefits to Mount Sinai School Of Medicine (New York, 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 Nicholas 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 Nicholas Russo was last updated on March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.