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

Michael J Russo, PT

Individual provider Orthopedic Physical Therapist · NPI 1265737563

Michael J Russo, PT is a Physical Therapist in Private Practice in Newport Beach, California. Qualified in 2007, 19 years ago. Practices with Wellness Tribe Physical Therapy Inc, a 2-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
19
Licensed in
CA
In the registry since
2011
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

20301 SW Acacia St Ste 150
Newport Beach, CA 92660-1741
Phone: (949) 274-9551
Fax: (949) 264-8219
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopedic Physical Therapist (primary) Taxonomy 2251X0800X · Licence 34635 (CA)

Record details

NPI number1265737563
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorYes
NPI enumeratedJanuary 18, 2011
Last updated in NPPESMarch 27, 2020
Certification dateMarch 27, 2020

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Wellness Tribe Physical Therapy Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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