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GORDON J RUSSO MD NPI 1083612469


NPI Information

NPI: 1083612469
Provider Name: GORDON J RUSSO, MD
Classification: Dermatology - 207NS0135X
Entity Type: Individual

Specialization: Procedural Dermatology

PECOS Registration: Yes

Address:
120 MEADOWCREST ST
SUITE 160
GRETNA, LA
ZIP 70056
Phone: (504) 391-7620
Get Directions

Gordon J Russo, MD is a procedural dermatology dermatology in Gretna, LA with 45 years of experience. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). Gordon J Russo, MD NPI is 1083612469. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduation Year:1979

The provider's business location address is:

120 MEADOWCREST ST
SUITE 160
GRETNA, LA
ZIP 70056-255
Phone: (504) 391-7620
Fax: (504) 391-7524

The NPI 1083612469 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of 2-14 skin growths (HCPCS:17003)
  • Destruction of skin growth (HCPCS:17000)
  • Destruction of up to 14 skin growths (HCPCS:17110)

The enumeration date for this NPI number is 7/11/2005 and was last updated on 2/3/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207NS0135XDermatologyProcedural Dermatology015208LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1B65886MEDICARE UPINLOUISIANA
255856MEDICARE ID-TYPE UNSPECIFIEDLOUISIANA
31329495MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.