Mark S Russo (NPI# 1316934326, PAC ID# 5698755106) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.
| Nation Provider ID (NPI) | 1316934326 |
| PAC ID by PECOS | 5698755106 |
| Professional Enrollment ID | I20060822000018 |
| Full Name | Mark S Russo |
| Organization Legal Name | NAPLES NEPHROLOGY P A |
| Address |
878 109th N Ave Naples FL 34108-1814 |
| Phone Number | 2395131002 |
| Gender | M |
| Credential | MD |
| Medical School | STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER |
| Graduation Year | 1995 |
| Primary Specialty | NEPHROLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 6507842010 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100286 | PHYSICIANS REGIONAL MEDICAL CENTER - PINE RIDGE |
| 100018 | NAPLES COMMUNITY HOSPITAL |
| 100244 | CAPE CORAL HOSPITAL - 100244 |
| 100012 | LEE MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 878 109th N Ave, Naples, FL 34108-1814 | 2395131002 | NAPLES NEPHROLOGY P A |
| Organization Legal Name | NAPLES NEPHROLOGY P A |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vera Stricevic | Nephrology | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Lauren Q Bledsoe | Physician Assistant | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Teresa M Liccardi | Nephrology | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Ellen G Lamanilao | Nurse Practitioner | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Sherry D Azar | Nurse Practitioner | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Stephen G Goldberger | Nephrology | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Street Address |
878 109TH N AVE |
| City | NAPLES |
| State | FL |
| Zip | 34108-1814 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vera Stricevic | Nephrology | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Lauren Q Bledsoe | Physician Assistant | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Teresa M Liccardi | Nephrology | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Ellen G Lamanilao | Nurse Practitioner | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Sherry D Azar | Nurse Practitioner | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Stephen G Goldberger | Nephrology | Naples Nephrology P A | 878 109th N Ave, Naples, FL 34108-1814 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alexandra M Olinsky | Certified Registered Nurse Anesthetist (crna) | Gulf-to-bay Anesthesiology Associates LLC | 850 111th N Ave, Naples, FL 34108-1803 |
| Chase R Contri | Certified Registered Nurse Anesthetist (crna) | Gulf-to-bay Anesthesiology Associates LLC | 850 111th N Ave, Naples, FL 34108-1803 |
| Daniel W Gorski | Anesthesiology | Gulf-to-bay Anesthesiology Associates LLC | 850 111th N Ave, Naples, FL 34108-1803 |
| Vincent Edward Guarini | Anesthesiology | Gulf-to-bay Anesthesiology Associates LLC | 850 111th N Ave, Naples, FL 34108-1803 |
| Mahesha Varma Thimmarayappa | Internal Medicine | 860 111th Ave N, Suite 5, Naples, FL 34108-1835 | |
| Jeffrey L Zimm | Ophthalmology | G B Fisher IIi Do Pa | 875 105th Ave N, Naples, FL 34108-1843 |
| Dan L Jefferies | Optometry | G B Fisher IIi Do Pa | 875 105th Ave N, Naples, FL 34108-1843 |
| Mark Anderson Sibley | Ophthalmology | G B Fisher IIi Do Pa | 875 105th Ave N, Naples, FL 34108-1843 |
| George B Fisher | Ophthalmology | G B Fisher IIi Do Pa | 875 105th Ave N, Naples, FL 34108-1843 |
| Jake Michael Rockman | Optometry | Eye Centers of Florida | 877 111th Ave N, Suite 2, Naples, FL 34108-1853 |
| Find all physicians in zip 34108 | |||
| City | NAPLES |
| Zip Code | 34108 |
| Specialty | NEPHROLOGY |
| City + Specialty | NAPLES + NEPHROLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.