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NICOLE RUSSO
NPI 1629831235
Nurse Practitioner - Family in Whitestone, NY

Active since February 05, 2024PECOS Enrolled
14919 17TH AVE, WHITESTONE, NY 11357(929) 428-0101 Get Directions Write a Review

NPPES record last updated: December 4, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 4, 2024, Feb 5, 2024 (2 updates tracked since 2024).

About Nicole Russo NPPES

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

NICOLE RUSSO (NPI 1629831235) is an individual family provider in Whitestone, New York, licensed in New York (F353455-01) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629831235
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameNICOLE RUSSO
Location Address14919 17TH AVEWhitestone, NY 11357-2539
Mailing Address14919 17th AveWhitestone, NY 11357-2539
Phone(929) 428-0101
Sole ProprietorNo
Enumeration DateFebruary 5, 2024
Last NPPES UpdateDecember 4, 20242 updates tracked since enumeration
NPPES CertifiedDecember 4, 2024
✔ NPI 1629831235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · F353455-01
14919 17TH AVE, Whitestone, NY 11357
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Russo 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 Nicole Russo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Shore-Lij Medical PC
5.7 mi
Urology
1010 NORTHERN BLVD STE 110
Great Neck, NY 11021
  • Reassigned Medicare billing, New York enrollment
  • 9,353 clinicians in this Medicare group
NPI 1053688572 (516) 321-7400

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 11357 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
$104.17 typical visit price
range $67.00 – $201.98
Typical copayment $26.04 (range $16.75 – $50.49)
Most-billed visit code 99203
Established Patient
$116.96 typical visit price
range $21.62 – $163.52
Typical copayment $29.24 (range $5.40 – $40.88)
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 1629831235. It was assigned to this individual provider in the NPPES registry on February 5, 2024.

Where is Nicole Russo located?

Nicole Russo practices at 14919 17th Ave, Whitestone, NY 11357. The listed phone number is (929) 428-0101.

What is Nicole Russo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Nicole Russo enrolled in Medicare?

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

Which organization bills Medicare for Nicole Russo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Russo reassigns Medicare benefits to North Shore-Lij Medical PC (Great Neck, 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 Nicole 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 Nicole Russo was last updated on December 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.