Gregory A Russo (NPI# 1750591400, PAC ID# 8123192044) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is RADIATION ONCOLOGY.
| Nation Provider ID (NPI) | 1750591400 |
| PAC ID by PECOS | 8123192044 |
| Professional Enrollment ID | I20151217001955 |
| Full Name | Gregory A Russo |
| Organization Legal Name | DARTMOUTH-HITCHCOCK CLINIC |
| Address |
1080 Hospital Dr Fresenius Medical Care St Johnsbury Dialysis Cente St Johnsbury VT 05819-9806 |
| Phone Number | 8027518735 |
| Gender | M |
| Medical School | UMDNJ-ROBERT WOOD JOHNSON MEDICAL SCHOOL |
| Graduation Year | 2003 |
| Primary Specialty | RADIATION ONCOLOGY |
| Group Practice PAC ID | 4183537509 |
| Number of Group Practice Members | 1198 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 300003 | MARY HITCHCOCK MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1 Medical Ctr Dr, Lebanon, NH 03756-1000 | 6036505000 | DARTMOUTH-HITCHCOCK CLINIC |
| 1 Medical Ctr Dr, Lebanon, NH 03756-1000 | MARY HITCHCOCK MEMORIAL HOSPITAL | |
| 1080 Hospital Dr, Fresenius Medical Care St Johnsbury Dialysis Cente, St Johnsbury, VT 05819-9806 | 8027518735 | DARTMOUTH-HITCHCOCK CLINIC |
| Organization Legal Name | DARTMOUTH-HITCHCOCK CLINIC |
| Physicians | 1178 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephanie M Winn | Nurse Practitioner | Dartmouth-hitchcock Clinic | 100 Hitchcock Way, Manchester, NH 03104-4125 |
| Anas Hannoun | Neurology | Dartmouth-hitchcock Clinic | 87 Mcgregor St, Manchester, NH 03102-3765 |
| Dillon H Young | Nurse Practitioner | Dartmouth-hitchcock Clinic | 117 Railroad St, Keene, NH 03431-3747 |
| Leah E Abrahamsen | Clinical Social Worker | Dartmouth-hitchcock Clinic | 85 Mechanic St, Suite 3b 1, Lebanon, NH 03766-1537 |
| Diane M Price | Nurse Practitioner | Dartmouth-hitchcock Clinic | 456 Woodstock Rd, C/o Woodstock Terrace, Woodstock, VT 05091-9759 |
| Joanne B Hayes | Nurse Practitioner | Dartmouth-hitchcock Clinic | 80 Lyme Rd, Hanover, NH 03755-1225 |
| Derek T Jurus | Obstetrics/gynecology | Dartmouth-hitchcock Clinic | 5 Washington Place, Bedford, NH 03110-6742 |
| Lauren J Welton | Physician Assistant | Dartmouth-hitchcock Clinic | 1 Elliot Way, Manchester, NH 03103-3502 |
| Latasha M Heape | Certified Registered Nurse Anesthetist (crna) | Dartmouth-hitchcock Clinic | 590 Court St, Keene, NH 03431-1719 |
| Elias E Loukas | Internal Medicine | Dartmouth-hitchcock Clinic | 1 Medical Ctr Dr, Lebanon, NH 03756-1000 |
| Street Address |
1080 HOSPITAL DR FRESENIUS MEDICAL CARE ST JOHNSBURY DIALYSIS CENTE |
| City | ST JOHNSBURY |
| State | VT |
| Zip | 05819-9806 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen A Skalla | Nurse Practitioner | Mary Hitchcock Memorial Hospital | 1080 Hospital Dr, Norris Cotton Can, St Johnsbury, VT 05819-9806 |
| Claire M Pace | Nurse Practitioner | Mary Hitchcock Memorial Hospital | 1080 Hospital Dr, Norris Cotton Can, St Johnsbury, VT 05819-9806 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jin Li Chan | Clinical Social Worker | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Thomas F Broderick | Family Medicine | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Adelaide Adjovu | Nurse Practitioner | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Joyce Vitale | Nurse Practitioner | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Eric Siegel | Obstetrics/gynecology | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, St Johnsbury, VT 05819-0905 |
| Claudia E Lee | Internal Medicine | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Jessica L Macleod | Nurse Practitioner | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Irene B Krechetoff | Internal Medicine | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Doreen J. Brado | Nurse Practitioner | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Kara Pitt | Obstetrics/gynecology | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Find all physicians in zip 05819 | |||
| City | ST JOHNSBURY |
| Zip Code | 05819 |
| Specialty | RADIATION ONCOLOGY |
| City + Specialty | ST JOHNSBURY + RADIATION ONCOLOGY |
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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.