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

Nicholas Joseph Russo

Individual provider Physical Therapist · NPI 1053915819

Nicholas Joseph Russo is a Physical Therapist in Private Practice in Eugene, Oregon. Qualified in 2020, 6 years ago. Practices with Ati Holdings of Arizona LLC, a 231-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Florida and Oregon.

Years since qualifying
6
Licensed in
FL, OR
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

1777 Coburg Rd Ste 3
Eugene, OR 97401-5477
Phone: (541) 505-8041
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 16811 N Litchfield Rd Ste 101, Surprise, AZ 85374-7062 — (602) 313-4045
  • 3800 Sun City Center Blvd, Sun City Center, FL 33573-6805 — (813) 633-9888

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT36549 (FL)
Physical Therapist Taxonomy 225100000X · Licence 66114 (OR)

Record details

NPI number1053915819
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 23, 2020
Last updated in NPPESJune 19, 2026
Certification dateJune 19, 2026
Mailing address1200 Corporate Dr Ste 400, Hoover, AL 35242-5424

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Ati Holdings Of Arizona Llc — 231 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Eugene