Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michael J Russo, PA

Individual provider Physician Assistant · NPI 1346447513

Michael J Russo, PA is a Physician Assistant in New York, New York. Qualified in 2007, 19 years ago. Practices with MSKCC Radiology Group, a 195-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Connecticut and New York.

Years since qualifying
19
Licensed in
CT, NY
In the registry since
2007
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1275 York Ave
New York, NY 10065-6007
Phone: (212) 639-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 80 Seymour St, Hartford, CT 06102 — (860) 545-3112
  • 85 Seymour St Ste 200, Hartford, CT 06106-5509 — (860) 246-9589

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 031904-01 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 001911 (CT)

Record details

NPI number1346447513
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 29, 2007
Last updated in NPPESJuly 2, 2024
Certification dateJuly 2, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Mskcc Radiology Group — 195 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Affiliated with 1 hospital, which CMS identifies by certification number only.

Colleagues at MSKCC Radiology Group

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 195 clinicians in the practice; 12 are shown here.

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