Doctor profile · Federal record

Dr. Nicholas Russo, MD

Family Medicine Physician · Student in an Organized Health Care Education/Training Program · New York, NY

  • NPI 1174151930
  • 6 yrs on file
  • Male
  • Group practice
  • No sanctions

Practice & contact

Operates at 2 locations .

NPPES Updated May 11, 2026
Primary practice
185 Broadway Fl 2
New York, NY 100070167
(415) 658-6791
fax (415) 252-7176
Additional location
30 Prospect Ave
Hackensack, NJ 076011915
(551) 996-2000
Mailing address
1 Embarcadero Ctr Ste 1900
San Francisco, CA 941113723

Credentials & registration

NPPES · NUCC
NPI registered
March 2020 — 6 yrs on file
Profile last updated
March 14, 2025
Specialty taxonomy
207Q00000X — NUCC code
State license (1)
New York #333488

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1174151930. Last verified May 11, 2026.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$135
Transactions
1
Manufacturers
1
Payer (manufacturer) Industry Txns Amount
Medtronic, INC. 1 $135.35

By nature of payment

Food and Beverage
$135

Frequently asked questions

Auto-generated from federal data
What is Dr. Nicholas Russo's medical specialty?
Dr. Nicholas Russo practices Family Medicine Physician in New York, NY.
Where does Dr. Nicholas Russo practice?
Dr. Nicholas Russo practices at 185 Broadway Fl 2, New York, NY 100070167. Office phone: 4156586791.
What is Dr. Nicholas Russo's NPI?
Dr. Nicholas Russo's National Provider Identifier (NPI) is 1174151930, issued by NPPES.