Shelly Russo, APRN - Medicare Nurse Practitioner in Venice, FL

Shelly Russo, APRN is a medicare enrolled "Nurse Practitioner - Gerontology" in Venice, Florida. Her current practice location is 1215 Jacaranda Blvd, Venice, Florida. You can reach out to her office (for appointments etc.) via phone at (941) 451-8282.

Shelly Russo is licensed to practice in Florida (license number 11021994) 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 1104549187.

Contact Information

Shelly Russo, APRN
1215 Jacaranda Blvd,
Venice, FL 34292-4520
(941) 451-8282
(877) 652-3059



Provider's Profile

Full NameShelly Russo
GenderFemale
SpecialityNurse Practitioner - Gerontology
Location1215 Jacaranda Blvd, Venice, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104549187
  • Provider Enumeration Date: 09/23/2022
  • Last Update Date: 09/23/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 7719354760
  • Enrollment ID: I20221103000478

Medical Identifiers

Medical identifiers for Shelly Russo such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104549187NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2200XNurse Practitioner - Adult Health 11021994 (Florida)Secondary
363LG0600XNurse Practitioner - Gerontology 11021994 (Florida)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. Shelly Russo allows following entities to bill medicare on her behalf.
Entity NameKi Hassler, Do, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508370909
PECOS PAC ID: 5496015737
Enrollment ID: O20180323000987

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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. Shelly 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 AddressPractice Location Address
Shelly Russo, APRN
1215 Jacaranda Blvd,
Venice, FL 34292-4520

Ph: (941) 451-8282
Shelly Russo, APRN
1215 Jacaranda Blvd,
Venice, FL 34292-4520

Ph: (941) 451-8282

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Nurse Practitioner Nurses in Venice, FL

Felicia Carnevale, ARNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 517 Riviera St Ste D, Venice, FL 34285
Phone: 941-244-9524    Fax: 941-244-9526
Destinee Renee Ogea,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 8431 Pointe Loop Dr Fl 1, Venice, FL 34293
Phone: 941-207-5350    Fax: 941-207-5352
Kristy L Petersen, ARNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 540 The Rialto, Venice, FL 34285
Phone: 941-486-6927    Fax: 941-486-6931
Judy Humphreys, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1287 Us Highway 41byp S, Venice, FL 34237
Phone: 941-244-5706    Fax: 941-800-4342
Ms. Kathryn S Collins, ARNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1211 Jacaranda Blvd, Venice, FL 34292
Phone: 844-366-9362    
Agata Wawro, ARNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 517 Riviera St Ste D, Venice, FL 34285
Phone: 941-244-9524    
Cynthia Beth Gamble, ARNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 600 Nokomis Ave S Ste 207, Venice, FL 34285
Phone: 941-486-6790    Fax: 941-486-6795

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