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

MS. Jacquelyn Kay Russell, PA

Individual provider Physician Assistant · NPI 1639156268

MS. Jacquelyn Kay Russell, PA is a Physician Assistant in Iliamna, Alaska. Qualified in 1997, 29 years ago. Practices with Southcentral Foundation, a 170-clinician group and accepts Medicare assignment. Licensed in Alaska, Illinois and New York.

Years since qualifying
29
Licensed in
AK, IL, NY
In the registry since
2005
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

101 Airport Way
Iliamna, AK 99606
Phone: (907) 571-1818
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PADA481 (AK)
Physician Assistant Taxonomy 363A00000X · Licence 085.004670 (IL)
Physician Assistant Taxonomy 363A00000X · Licence 023071 (NY)

Record details

NPI number1639156268
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 23, 2005
Last updated in NPPESSeptember 6, 2024
Certification dateAugust 30, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Southcentral Foundation — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients26
Services billed 114 a service is one billed item, such as a visit, a test or a procedure
Average patient age72

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Southcentral Foundation

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 170 clinicians in the practice; 12 are shown here.

Other providers in Iliamna