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

Q: 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.

Q: What is Nicholas Russo's specialty?

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

Q: 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 17 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.

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: August 16, 2026.

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

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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.

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

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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)

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.

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)