DOMENICK RUSSOLELLO – Physical Therapist, NPI 1750836078

DOMENICK RUSSOLELLO is a healthcare provider. based in Campbell hall, New York. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 040777 (NY). The NPI Number for DOMENICK RUSSOLELLO is 1750836078

Main info

Male
10 Years Of Experience
Name
DOMENICK RUSSOLELLO
NPI
1750836078
Phone
(845) 636-4344
Address
16 MAYBROOK RD
Enumeration Date
16 August 2016
Last Update Date
16 August 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9142450298
Graduation Year
2016 (10 years ago)
PAC ID
7315234671
Group Practice PAC ID
8527338847
Professional Enrollment ID
I20160929002731
Address ID
NY105984543YO334XXAVEX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

8,725 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NY

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Provider Addresses for DOMENICK RUSSOLELLO

  • Maybrook Road, Campbell Hall, Town of Hamptonburgh, Orange, New York, 10916, United States

    STE A

    CAMPBELL HALL, NY 109162743

    Phone: (845) 636-4344

    Fax: (845) 636-4355

    Type: Mailing

  • 55, Amandas Way, Town of La Grange, Dutchess County, New York, 12540, United States

    STE A

    LAGRANGEVILLE, NY 125405005

    Phone: (845) 895-1115

    Fax: (845) 895-1116

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-01-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160929002731IPhysical Therapist In Private PracticeNYTBD
I20180117000811IPhysical Therapist In Private PracticeCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97140Therapy procedure using manual technique, each 15 minutes1,930138$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes1,631129$0
97530Therapy procedure using functional activities1,496106$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1,338106$0
97116Therapy procedure for walking training, each 15 minutes15111$0
View full utilization report →

Insurance plans in this area (ZIP 10916)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8527338847View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeCT

Reviews

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Frequently asked questions

Where can patients find DOMENICK RUSSOLELLO's NPI?
You can confirm DOMENICK RUSSOLELLO with NPI 1750836078; it appears in the national provider directory.
Is DOMENICK RUSSOLELLO's NPI currently valid?
The extract we use shows DOMENICK RUSSOLELLO as active.
What field does DOMENICK RUSSOLELLO work in?
You can think of DOMENICK RUSSOLELLO as practicing within Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is DOMENICK RUSSOLELLO's primary listing?
We display Campbell Hall, New York because that is what the record indicates for DOMENICK RUSSOLELLO.
Is DOMENICK RUSSOLELLO a real provider?
This page reflects official NPPES data for NPI 1750836078. Always confirm identity and privileges with the practice and licensing boards.

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