DR. RUSSELL PENDLETON (DPM) – Foot & Ankle Surgery Podiatrist, NPI 1932356789
Foot & Ankle Surgery Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,097 PODIATRY in TX
Provider Addresses for DR. RUSSELL PENDLETON (DPM)
101 Crown Pointe Blvd Ste 240
Willow Park, TX 760871192
Phone: (817) 400-2004
Fax: (888) 843-5379
Type: Location
6312, Azle Avenue, Lake Worth, Tarrant County, Texas, 76135, United States
LAKE WORTH, TX 761352442
Phone: (817) 238-8400
Fax: (817) 238-8401
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 14 Open Payments records for all available years, with a total value of $494.
Total Amount is formed as General ($494) + Research ($0) + Ownership ($0) = $494.
Last reported payment date: 2024-07-31 • Largest payer in this snapshot: Pylant Medical ($126).
Total Amount
$494
General + Research + Ownership
Payments
14
Total payment records
General Amount
$494
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-31
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2010-08-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100803000201 | I | Podiatry | TX | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 400 | 278 | $0 |
| 11720 | Removal of fingernails or toenails, 1-5 nails | 206 | 87 | $0 |
| 11719 | Trimming of fingernails or toenails | 196 | 83 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 183 | 183 | $0 |
| 11056 | Removal of noncancer thickened skin growth, 2-4 growths | 99 | 50 | $0 |
Insurance plans in this area (ZIP 76087)
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Provider's Procedures
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