Thomas Joseph Russell, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

15093020 Issued in WI

Practice address

13800 W North Ave
Ste 100
Brookfield, WI 53005-4974

Phone

(262) 754-4488

Fax

(262) 754-4940

NPI assigned

Aug 30, 2005

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Affiliated Dermatologists SC

  • Dermatology Physician
  • Brookfield, WI
  • NPI 1407849011
  Medicare reassignment NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Dermatology

  Medicare reassignment NPD
• Affiliated Dermatologists, SC

  • MOHS-Micrographic Surgery Physician
  • Oak Creek, WI
  • NPI 1316656721

  Dermatology

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1528051166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 W NORTH AVE",
            "address_2": "STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054974",
            "telephone_number": "262-754-4488",
            "fax_number": "262-754-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 W NORTH AVE",
            "address_2": "STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054974",
            "telephone_number": "262-754-4488",
            "fax_number": "262-754-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "15093020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30899900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Ruiz
• Nataliya Runtova
• Rur, LLC.
• Rebecca R. Rusch, NP
• James Patrick Russell, MD
• Russo Dental LLC
• Nicholas Vito Russo, D.D.S.
• Stephanie Rutkowski
• Diane Kay Rutsch
• Randall Ruvalcaba, MD

• Dermatology Physician in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Dermatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.