Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Russell Blankenburg, MD

Individual provider Internal Medicine Physician · NPI 1104893577

Dr. Russell Blankenburg, MD is an Internal Medicine in Brookfield, Wisconsin. Graduated from University of Wisconsin School of Medicine in 1993, 33 years ago. Practices with Ascension Medical Group-Southeast Wisconsin Inc, a 555-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
33
Trained at
University of Wisconsin School of Medicine
Licensed in
WI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

17000 W North Ave Ste 200E
Brookfield, WI 53005-4423
Phone: (262) 782-4270
Fax: (262) 784-9319
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 35536 (WI)

Record details

NPI number1104893577
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 3, 2006
Last updated in NPPESDecember 7, 2009
Mailing address17000 W North Ave, Brookfield, WI 53005-4423

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 1993 (33 years in practice)
Group practice Ascension Medical Group-Southeast Wisconsin Inc — 555 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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