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

Mary Russo, DO

Individual provider Emergency Medicine Physician · NPI 1023421864

Mary Russo, DO is an Emergency Medicine in Pueblo, Colorado. Graduated from Midwestern University, Chicago College of Osteopathic Med in 2014, 12 years ago. Practices with Southern Colorado Emergency Medical Associates, a 26-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado and Michigan.

Years since qualifying
12
Trained at
Midwestern University, Chicago College of Osteopathic Med
Licensed in
CO, MI
In the registry since
2014
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

400 W 16th St
Pueblo, CO 81003-2745
Phone: (719) 584-4306
Fax: (719) 595-7886
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1000 Oakland Dr, Kalamazoo, MI 49008-1282 — (269) 337-4400

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence DR.0058320 (CO)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 5101021285 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 5101021285 (MI)

Record details

NPI number1023421864
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 10, 2014
Last updated in NPPESJuly 21, 2022
Mailing address400 W 16th St, Pueblo, CO 81003-2745

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolMIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduated 2014 (12 years in practice)
Group practice Southern Colorado Emergency Medical Associates — 26 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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