RUSSELL E. RISMA (M.D.) – Family Medicine Physician, NPI 1104963842

RUSSELL E. RISMA (M.D.) is a healthcare provider. based in Miramar, Florida. specializing in FAMILY PRACTICE, PERIPHERAL VASCULAR DISEASE. They hold the professional credentials M.D.. They hold a License No. 29184 (CO). The NPI Number for RUSSELL E. RISMA (M.D.) is 1104963842

Main info

Male
Sole Proprietor
44 Years Of Experience
Accepts Medicare Assignment
Name
RUSSELL E. RISMA (M.D.)
NPI
1104963842
Phone
(877) 866-7123
Address
3601 SW 160TH AVE
Enumeration Date
31 January 2007
Last Update Date
5 December 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8778667123
Graduation Year
1982 (44 years ago)
PAC ID
4284957077
Group Practice PAC ID
5890931331
Professional Enrollment ID
I20141231001625
Address ID
CO804879163ST2855XTRLX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

6,722 FAMILY PRACTICE in FL

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Provider Addresses for RUSSELL E. RISMA (M.D.)

  • Southwest 160th Avenue, Miramar, Broward County, Florida, 33027-4145, United States

    SUITE 250

    MIRAMAR, FL 330276308

    Phone: (877) 866-7123

    Type: Location

  • 2412, Sheffield Circle West, Lexington Green, Fort Collins, Larimer County, Colorado, 80526, United States

    FORT COLLINS, CO 805261636

    Phone: (970) 310-5302

    Type: Mailing

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: 2014-12-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20141231001625IFamily PracticeCOTBD

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
11042Removal of skin and tissue, 20.0 sq cm or less545133$0
11043Removal of muscle and/or tissue, 20.0 sq cm or less31254$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes18579$0
17250Application of chemical to stop tissue regrowth in wound13529$0
97597Removal of tissue from wound, 20.0 sq cm or less11140$0
View full utilization report →

Insurance plans in this area (ZIP 33027)

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Provider's Procedures

RUSSELL E. RISMA (M.D.) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEFL11042Removal of skin and tissue first 20 sq cm or less531117

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: 5890931331View full group profile
NameSpecialtyState
Family PracticeKY
Family Practice, Peripheral Vascular DiseaseCO
General Surgery, Peripheral Vascular DiseaseIN
General PracticeCO
Family Practice, Peripheral Vascular DiseaseIN
-GA
-IN
Nurse PractitionerIL
Family Practice, Peripheral Vascular DiseaseIN
General SurgeryIN

Reviews

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Frequently asked questions

Where can patients find RUSSELL E. RISMA (M.D.)'s NPI?
You can confirm RUSSELL E. RISMA (M.D.) with NPI 1104963842; it appears in the national provider directory.
Is RUSSELL E. RISMA (M.D.) currently active in the NPI registry?
CMS-published data lists RUSSELL E. RISMA (M.D.) as an active registrant.
What kind of provider is RUSSELL E. RISMA (M.D.)?
The page reflects Family Medicine Physician for RUSSELL E. RISMA (M.D.). Clinical services aligned with this taxonomy classification.
Where is RUSSELL E. RISMA (M.D.)'s primary listing?
We display Miramar, Florida because that is what the record indicates for RUSSELL E. RISMA (M.D.).
Is RUSSELL E. RISMA (M.D.) a real provider?
This page reflects official NPPES data for NPI 1104963842. Always confirm identity and privileges with the practice and licensing boards.

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