Active NPI 1134643315 Individual Practitioner Female Practitioner

Jackie Marie Russo , NP

Nurse Practitioner • Miramar, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Jackie Russo, NP is a certified Nurse Practitioner practicing in Miramar, FL. With approximately 10 years of clinical experience since completing medical education in 2016, Jackie Russo delivers high-quality medical care to the local community at 12600 PEMBROKE RD STE 310.

Jackie Russo is affiliated with Angelo Ayar Md Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, tangential biopsy of single skin lesion. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

12600 Pembroke Rd Ste 310

Miramar, FL 330272544

Telephone 9544317681

Fax 9544317682

Associated Practice Facility / Clinic

🏢 Dermatology Consultants Pa Facility NPI 1689815904

Medicare Profile & Education

Medical School

Other

Graduation Year

2016

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Miramar, FL

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

10 Yrs +1.7 yrs vs City Avg

City Avg: 8.3 Yrs

State Avg: 10.0 Yrs

Regional Practice Density

56 Specialists

Practicing in Miramar, FL (8990 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

33.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Russo (10 Years) 10 Yrs

Miramar Specialty Average (8.3 Years) 8.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	183	25	$11.65	$5.90
99213 Established patient office or other outpatient visit, typically 15 minutes	85	71	$116.44	$81.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	37	30	$164.18	$114.44
11102 Tangential biopsy of single skin lesion	36	35	$127.36	$72.13
17000 Destruction of skin growth	35	32	$86.45	$40.41
17110 Destruction of up to 14 skin growths	33	32	$144.45	$103.07
17004 Destruction of precancer skin growth, 15 or more growths	22	20	$213.75	$152.41
17111 Destruction of skin growth, 15 or more growths	19	17	$169.08	$119.81
11103 Biopsy of related skin growth, each additional growth	17	12	$63.72	$41.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	12	12	$116.93	$79.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	327	20	$12.64	$5.95
99213 Established patient office or other outpatient visit, typically 15 minutes	61	45	$175.93	$82.74
11103 Biopsy of related skin growth, each additional growth	53	26	$99.34	$46.80
11102 Tangential biopsy of single skin lesion	44	39	$199.07	$84.11
17000 Destruction of skin growth	30	24	$131.57	$37.20
17110 Destruction of up to 14 skin growths	18	15	$219.69	$103.34
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	16	$111.24	$52.39
17004 Destruction of precancer skin growth, 15 or more growths	14	12	$327.15	$153.79
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$223.58	$105.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	513	32	$12.11	$5.73
11103 Biopsy of related skin growth, each additional growth	157	57	$102.46	$48.49
99213 Established patient office or other outpatient visit, typically 15 minutes	155	88	$176.73	$83.59
11102 Tangential biopsy of single skin lesion	110	82	$199.31	$83.87
17110 Destruction of up to 14 skin growths	54	35	$217.60	$102.91
17000 Destruction of skin growth	53	41	$127.52	$40.37
17004 Destruction of precancer skin growth, 15 or more growths	34	26	$317.79	$150.45
99441 Telephone medical discussion with physician, 5-10 minutes	28	27	$108.38	$51.23
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	19	$108.31	$51.09
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	20	16	$250.18	$118.12
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$221.79	$104.98
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$143.95	$68.10

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	671	41	$11.21	$5.26
99213 Established patient office or other outpatient visit, typically 15 minutes	244	146	$145.15	$68.31
11103 Biopsy of related skin growth, each additional growth	198	81	$104.10	$48.90
11102 Tangential biopsy of single skin lesion	152	112	$194.46	$81.86
17000 Destruction of skin growth	60	44	$126.81	$38.73
17110 Destruction of up to 14 skin growths	41	32	$216.65	$101.94
99202 New patient office or other outpatient visit, typically 20 minutes	29	29	$149.34	$70.48
17004 Destruction of precancer skin growth, 15 or more growths	28	25	$306.25	$143.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	15	$207.68	$97.60
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	11	$89.05	$41.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	33	32	$141.02	$66.20
11103 Biopsy of related skin growth, each additional growth	28	13	$103.88	$48.27
11102 Tangential biopsy of single skin lesion	19	19	$192.14	$72.95
17000 Destruction of skin growth	14	14	$128.77	$44.55

Medical Specialties & State Licenses

CMS Verified: 2022-03-02

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License FL ARNP9295134

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Hospital & Practice Group Affiliations

Angelo Ayar Md Pa

7301 N University Dr, Tamarac, FL 333212909

Phone: 9547262000

Secondary Practice Locations

7150 W 20th Ave Ste 210

Hialeah, FL 330165531

Phone: 3058287504

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners

Dr. Jose Mendez , DO

Dermatology

NPI 1033101175

Doctor of Osteopathic Medicine (D.O.)

Jessica Marin

Nurse Practitioner

NPI 1285469882

Kimberly Bisogno , ARNP

Nurse Practitioner

NPI 1447574462

Advanced Registered Nurse Practitioner

Catherine Balestra

Dermatology

NPI 1518177013

Sindhu Jayaram , PA

Physician Assistant

NPI 1548989023

Physician Assistant

Jennifer Penichet , ARNP

Nurse Practitioner

NPI 1679943930

Advanced Registered Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location March 02, 2022

Registered at 12600 PEMBROKE RD STE 310, MIRAMAR, FL 330272544 (Tel: 9544317681)

📍

Updated Business Mailing Address March 02, 2022

Registered at 12600 PEMBROKE RD STE 310, MIRAMAR, FL 330272544 (Tel: 9544317681)

👤

Provider Name / Credentials Updated March 02, 2022

Recorded as JACKIE RUSSO, NP

✅

NPI Profile Active July 31, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location July 31, 2017

Registered at 12600 PEMBROKE RD STE 312, MIRAMAR, FL 330272544 (Tel: 9544317681)

📍

Updated Business Mailing Address July 31, 2017

Registered at 151 SOUTHHALL LN STE 300, MAITLAND, FL 327517172 (Tel: 4078752080)

👤

Provider Name / Credentials Updated July 31, 2017

Recorded as JACKIE RUSSO

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 31, 2017

Nurse Practitioner (License #ARNP9295134 in FL)

🟢

Initial NPI Registration & Enumeration July 31, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1134643315

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 31, 2017

Last Update: March 02, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

12600 Pembroke Rd Ste 310

Miramar, FL 330272544

Phone: 9544317681

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.