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NICOLE MARIE RUSSO MSN, RN, CCRN, CPNP
NPI 1518859545
Nurse Practitioner - Pediatrics in Stony Brook, NY

Active since July 15, 2025PECOS Enrolled
HSC T11-020, STONY BROOK, NY 11794(516) 306-6989 Get Directions Write a Review

NPPES record last updated: December 21, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Nicole Marie Russo Msn, Rn, Ccrn, Cpnp NPPES

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

NICOLE MARIE RUSSO MSN, RN, CCRN, CPNP (NPI 1518859545) is an individual pediatrics provider in Stony Brook, New York, licensed in New York (393742) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1518859545
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameNICOLE MARIE RUSSOCredential: MSN, RN, CCRN, CPNP
Location AddressHSC T11-020Stony Brook, NY 11794-0001
Mailing Address101 Nicolls RdStony Brook, NY 11794-8111 · (631) 620-4195
Phone(516) 306-6989
Sole ProprietorNo
Enumeration DateJuly 15, 2025
Last NPPES UpdateDecember 21, 2025
NPPES CertifiedDecember 21, 2025
✔ NPI 1518859545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in NY · 393742
Also ListedRegistered NurseTaxonomy 163W00000X · License 776987 (NY)
HSC T11-020, Stony Brook, NY 11794
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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)

Nicole Marie Russo Msn, Rn, Ccrn, Cpnp 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 11794 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

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 Nicole Russo's NPI number?

The NPI number for Nicole Russo is 1518859545. It was assigned to this individual provider in the NPPES registry on July 15, 2025.

Where is Nicole Russo located?

Nicole Russo practices at Hsc T11-020, Stony Brook, NY 11794. The listed phone number is (516) 306-6989.

What is Nicole Russo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Nicole Russo enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Nicole Russo was last updated on December 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.