MR. PETER JOSEPH RUSSO PA
NPI 1588729941
Physician Assistant in Stockton, CA

Q: What is Peter Russo's NPI number?

The NPI number for Peter Russo is 1588729941. It was assigned to this individual provider in the NPPES registry on December 26, 2006.

Q: What is Peter Russo's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Peter Russo was last updated on April 10, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since December 26, 2006PECOS Enrolled

2545 W HAMMER LN, STOCKTON, CA 95209(209) 957-7050 Get Directions Write a Review

NPPES record last updated: April 10, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Peter Joseph Russo Pa NPPES

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

MR. PETER JOSEPH RUSSO PA (NPI 1588729941) is an individual physician assistant in Stockton, California, licensed in California (PA14699) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588729941

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. PETER JOSEPH RUSSOCredential: PA

Location Address2545 W HAMMER LNStockton, CA 95209-2839

Mailing Address600 Coffee RdModesto, CA 95355-4201 · (209) 521-6097

Phone(209) 957-7050

Sole ProprietorNo

Enumeration DateDecember 26, 2006

Last NPPES UpdateApril 10, 2015

✔ NPI 1588729941 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in CA · PA14699

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License PA14699 (CA)

2545 W HAMMER LN, Stockton, CA 95209

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Other Identifiers 1

OtherCD069ACA · Group Ptan-greater Modesto Medical Surgical Associates

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Peter Joseph Russo Pa 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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

13 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95209 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

$90.32 typical visit price

range $58.87 – $176.60

Typical copayment $22.58 (range $14.71 – $44.15)

Most-billed visit code 99203

Established Patient

$73.16 typical visit price

range $19.28 – $144.60

Typical copayment $18.29 (range $4.82 – $36.15)

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.

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