Jacquelyn Kay Russell, PA
NPI 1639156268ActiveIndividual· Physician Assistant· Iliamna, AK
Physician Assistant (PA) with Southcentral Foundation, practicing in Iliamna, Alaska. Their prescriptions cost Medicare Part D more than their services did: $20,562 for 172 claims, against $4,662 paid for services in 2024. Lists Alaska Native Medical Center as a hospital affiliation.
Overview
| NPI | 1639156268 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA |
| Sole proprietor | No |
| NPI issued | Dec 23, 2005 |
| Last updated in NPPES | Sep 6, 2024 |
| Certified by provider | Aug 30, 2024 |
| Reactivated | Aug 30, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PADA481 | AK |
| Physician Assistant | 363A00000X | 085.004670 | IL |
| Physician Assistant | 363A00000X | 023071 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 26 |
|---|---|
| Services billed | 114 across 39 procedure codes |
| Paid by Medicare | $4,662 |
Part D prescriptions in 2024
| Prescriptions (claims) | 172 · 406 30-day fills |
|---|---|
| Patients | 21 |
| Total drug cost | $20,562 |
| Generic share | 84% of claims |
Education and affiliations
| Graduation year | 1997 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Southcentral FoundationWasilla, AK · 167 clinicians
Hospital affiliation
- Alaska Native Medical CenterAnchorage, AK
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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