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

Jack Russo, MD

Individual provider Otolaryngology Physician · NPI 1689990616

Jack Russo, MD is an Otolaryngology in Brooklyn, New York. Graduated from University of California, Davis School of Medicine in 2010, 16 years ago. Practices with ENT and Allergy Associates LLP, a 432-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
16
Trained at
University of California, Davis School of Medicine
Licensed in
NY
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

300 Cadman Plz W Ste 1301
Brooklyn, NY 11201-3229
Phone: (718) 208-4449
Fax: (718) 208-4663
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence 277526 (NY)

Record details

NPI number1689990616
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 15, 2010
Last updated in NPPESFebruary 4, 2019

Medicare enrollment

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

Medicare specialtyOTOLARYNGOLOGY
Medical schoolUNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduated 2010 (16 years in practice)
Group practice Ent And Allergy Associates Llp — 432 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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