THOMAS JOSEPH RUSSELL (MD) – Dermatology Physician, NPI 1528051166

THOMAS JOSEPH RUSSELL (MD) is a healthcare provider. based in Brookfield, Wisconsin. specializing in Dermatology Physician. They hold the professional credentials MD. They hold a License No. 15093020 (WI). The NPI Number for THOMAS JOSEPH RUSSELL (MD) is 1528051166

Main info

Male
64 Years Of Experience
Accepts Medicare Assignment
Name
THOMAS JOSEPH RUSSELL (MD)
NPI
1528051166
Phone
(262) 754-4488
Address
13800 W NORTH AVE
Enumeration Date
30 August 2005
Last Update Date
20 April 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2627544488119
Graduation Year
1962 (64 years ago)
PAC ID
0446297014
Group Practice PAC ID
8123065794
Professional Enrollment ID
I20060918000438
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for THOMAS JOSEPH RUSSELL (MD)

  • 13800, West North Avenue, Brookfield, Waukesha County, Wisconsin, 53005, United States

    STE 100

    BROOKFIELD, WI 530054974

    Phone: (262) 754-4488

    Fax: (262) 754-4940

    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)

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: 2006-09-18

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
I20060918000438IDermatologyWITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 53005)

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Provider's Procedures

THOMAS JOSEPH RUSSELL (MD) performs procedures in Dermatology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYWI17003Destruction of 2-14 skin growths6619

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: 8123065794View full group profile
NameSpecialtyState
D E R M A T O L O G YWI
Micrographic Dermatologic Surgery (Mds), DermatologyOH
Physician AssistantWI
D E R M A T O L O G YWI
D E R M A T O L O G YWI
D E R M A T O L O G YWI
D E R M A T O L O G YWI
-WI
D E R M A T O L O G YWI
D E R M A T O L O G YWI

Reviews

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Frequently asked questions

What federal number belongs to THOMAS JOSEPH RUSSELL (MD)?
The federal identifier for THOMAS JOSEPH RUSSELL (MD) is NPI 1528051166.
Is THOMAS JOSEPH RUSSELL (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does THOMAS JOSEPH RUSSELL (MD) treat or focus on?
Patients typically see THOMAS JOSEPH RUSSELL (MD) under the specialty Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where is THOMAS JOSEPH RUSSELL (MD)'s primary listing?
We display Brookfield, Wisconsin because that is what the record indicates for THOMAS JOSEPH RUSSELL (MD).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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