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

Dr. Randolph B Russo, MD

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1306833470

Dr. Randolph B Russo, MD is a Physical Medicine and Rehabilitation in Grand Rapids, Michigan. Graduated from Wayne State University School of Medicine in 1990, 36 years ago. Practices with Orthopaedic Associates of Grand Rapids PC, a 86-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
36
Trained at
Wayne State University School of Medicine
Licensed in
MI
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone: (616) 459-7101
Fax: (616) 464-6170
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 4301056466 (MI)

Record details

NPI number1306833470
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 4, 2005
Last updated in NPPESDecember 9, 2019
Certification dateDecember 9, 2019
Mailing address1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406

Medicare enrollment

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

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolWAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated 1990 (36 years in practice)
Group practice Orthopaedic Associates Of Grand Rapids Pc — 86 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Grand Rapids