DR. RUSSELL BLANKENBURG (MD) – Internal Medicine Physician, NPI 1104893577
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,939 INTERNAL MEDICINE in WI
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Provider Addresses for DR. RUSSELL BLANKENBURG (MD)
17000, West North Avenue, Brookfield, Waukesha County, Wisconsin, 53005, United States
BROOKFIELD, WI 530054423
Phone: (262) 782-4270
Fax: (262) 784-9319
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $260.
Total Amount is formed as General ($260) + Research ($0) + Ownership ($0) = $260.
Last reported payment date: 2024-09-20 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($122).
Total Amount
$260
General + Research + Ownership
Payments
4
Total payment records
General Amount
$260
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $122 |
| IDORSIA PHARMACEUTICALS US INC | $112 |
| Exact Sciences Corporation | $25 |
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: 2004-05-04
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 |
|---|---|---|---|---|
| I20040504000957 | I | Internal Medicine | WI | 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 |
|---|---|---|---|---|
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 224 | 224 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 173 | 119 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 134 | 98 | $0 |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 15 | 13 | $0 |
| G0009 | Administration of pneumococcal vaccine | 15 | 15 | $0 |
Insurance plans in this area (ZIP 53005)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Mental Health Counselor | WI | |
| - | WI | |
| Internal Medicine | WI | |
| Hospitalist, Internal Medicine | WI | |
| U R O L O G Y | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | WI | |
| - | OH | |
| - | WI | |
| - | WI |
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