Ms Susan Marie Russo, is a medicare enrolled "Nurse Practitioner - Family" physician in Sterling Heights, Michigan. Her current practice location is
14500 Hall Rd, Sterling Heights, Michigan. You can reach out to her office (for appointments etc.) via phone at
(800) 653-6568.
Ms Susan Marie Russo is licensed to practice in Michigan (license number 4704189539) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1629714936.
Physician's Profile
| Full Name | Ms Susan Marie Russo |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 14500 Hall Rd, Sterling Heights, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1629714936
- Provider Enumeration Date: 05/10/2022
- Last Update Date: 12/20/2022
Medicare PECOS Information:
- PECOS PAC ID: 5890165484
- Enrollment ID: I20221222001187
Medical Identifiers
Medical identifiers for Ms Susan Marie Russo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629714936 | NPI | - | NPPES |
| 4704189539 | Other | MI | FAMILY NURSE PRACTITIONER |
| 4704189539 | Medicaid | MI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 4704189539 (Michigan) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 4704189539 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Susan Marie Russo allows following entities to bill medicare on her behalf.
| Entity Name | Henry Ford Health System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104900455
PECOS PAC ID: 0547178311
Enrollment ID: O20031210000341 |
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| Entity Name | Henry Ford Macomb Hospital Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1952440521
PECOS PAC ID: 7911808381
Enrollment ID: O20040617000651 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Susan Marie Russo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ms Susan Marie Russo,
1 Ford Pl Ste 3a,
Detroit, MI 48202-3450
Ph: (313) 876-9490 | Ms Susan Marie Russo,
14500 Hall Rd,
Sterling Heights, MI 48313-1229
Ph: (800) 653-6568 |
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