KIMBERLY ANN RUSSELL (PA) – Physician Assistant, NPI 1184487548

KIMBERLY ANN RUSSELL (PA) is a healthcare provider. based in Schaumburg, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 085.010266 (IL). The NPI Number for KIMBERLY ANN RUSSELL (PA) is 1184487548

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY ANN RUSSELL (PA)
NPI
1184487548
Phone
(847) 278-1347
Address
800 W. WOODFIELD RD.
Enumeration Date
30 January 2024
Last Update Date
18 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7738491942
Graduation Year
2023 (3 years ago)
PAC ID
6406290691
Group Practice PAC ID
9537607072
Professional Enrollment ID
I20240215001938
Address ID
IL601734763SC800XXRDXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:2State licenses:1Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for KIMBERLY ANN RUSSELL (PA)

  • 800 W. WOODFIELD RD.

    SUITE 106

    SCHAUMBURG, IL 60173

    Phone: (847) 278-1347

    Fax: (847) 285-1610

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240215001938IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60173)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537607072View full group profile
NameSpecialtyState
Pulmonary Disease, Internal MedicineNY
Nurse PractitionerIL
Internal MedicineIL
Pulmonary DiseaseTX

Reviews

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Frequently asked questions

Is KIMBERLY ANN RUSSELL (PA) listed with a National Provider Identifier?
Yes — KIMBERLY ANN RUSSELL (PA) has NPI 1184487548 on file in the registry.
Would KIMBERLY ANN RUSSELL (PA) appear as active to a payer?
You can treat KIMBERLY ANN RUSSELL (PA) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with KIMBERLY ANN RUSSELL (PA)?
KIMBERLY ANN RUSSELL (PA)'s record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with KIMBERLY ANN RUSSELL (PA)?
Directory geography for KIMBERLY ANN RUSSELL (PA) centers on Schaumburg, Illinois.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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