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

Individual provider Physician Assistant · NPI 1952113748

John Russo, PA is a Physician Assistant in New York, New York. Qualified in 2024, 2 years ago. Registered with an NPI since 2025.

Years since qualifying
2
In the registry since
2025
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

525 E 68th St
New York, NY 10065-4870
Phone: (212) 746-5454
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1952113748
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 21, 2025
Last updated in NPPESJanuary 21, 2025
Certification dateJanuary 21, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

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

Other providers in New York