PETER DAMON RUSSOTTO DPM NPI 1770576829

NPI Details

Peter Damon Russotto, DPM is a podiatrist in Jacksonville, IL. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. Peter Damon Russotto, DPM NPI is 1770576829. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1440 W WALNUT ST
#5
JACKSONVILLE, IL
ZIP 62650-143
Phone: (217) 243-3668

The NPI 1770576829 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Trimming of dystrophic nails, any number (HCPCS:G0127)
• Removal of tissue from wound, 20.0 sq cm or less (HCPCS:97597)
• Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
• Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
• Removal of noncancer thickened skin growth, 2-4 growths (HCPCS:11056)
• Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
• New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
• New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
• Removal of noncancer thickened skin growth, 1 growth (HCPCS:11055)
• Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
• Permanent removal fingernail or toenail (HCPCS:11750)
• Simple separation of fingernail or toenail from nail bed, first nail (HCPCS:11730)

The enumeration date for this NPI number is 8/24/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.