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

Kelly Russo

Individual provider Pediatric Nutrition Registered Dietitian · NPI 1275495855

Kelly Russo is a Registered Dietitian OR Nutrition Professional in Rochester, New York. Qualified in 2003, 23 years ago. Licensed in New York.

Years since qualifying
23
Licensed in
NY
In the registry since
2025

Practice location Address checks out

601 Elmwood Ave
Rochester, NY 14642-0001
Phone: (585) 275-2647
Show map & directions

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

Specialties & licences

Pediatric Nutrition Registered Dietitian (primary) Taxonomy 133VN1004X · Licence 917553 (NY)

Record details

NPI number1275495855
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 2, 2025
Last updated in NPPESFebruary 6, 2026
Certification dateFebruary 6, 2026

Medicare enrollment

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

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Accepts Medicare assignment Not indicated