RAQUEL K RUSSO (PA-C) – Physician Assistant, NPI 1013545607

RAQUEL K RUSSO (PA-C) is a healthcare provider. based in Saint louis, Missouri. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 2022005794 (MO). The NPI Number for RAQUEL K RUSSO (PA-C) is 1013545607

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
RAQUEL K RUSSO (PA-C)
NPI
1013545607
Phone
Not provided
Address
4041 CHOUTEAU AVE APT 441
Enumeration Date
30 March 2020
Last Update Date
17 November 2025

Doctor Profile

Medical School Name
SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6367782900
Graduation Year
2021 (5 years ago)
PAC ID
8729475520
Group Practice PAC ID
1456599141
Professional Enrollment ID
I20220426001457
Address ID
MO636402970FA160XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness85
Years active:6State licenses:1Digital endpointsOther names

1,853 PHYSICIAN ASSISTANT in MO

Provider Addresses for RAQUEL K RUSSO (PA-C)

  • 4041 CHOUTEAU AVE APT 441

    SAINT LOUIS, MO 631101751

    Phone:

    Type: Mailing

  • 3437 CAROLINE ST

    SAINT LOUIS, MO 631041111

    Phone: (314) 977-8521

    Type: Location

  • 13353 OLIVE BLVD

    CHESTERFIELD, MO 630173108

    Phone: (636) 778-2900

    Fax: (636) 778-2828

    Type: Mailing

  • 17300 N OUTER 40 RD STE 201

    CHESTERFIELD, MO 630051364

    Phone: (636) 778-2900

    Fax: (636) 778-2828

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $85.

Total Amount is formed as General ($85) + Research ($0) + Ownership ($0) = $85.

Last reported payment date: 2024-05-09 • Largest payer in this snapshot: SANOFI-AVENTIS U.S. LLC ($31).

Total Amount

$85

General + Research + Ownership

Payments

5

Total payment records

General Amount

$85

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2022-04-26

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
I20220426001457IPhysician AssistantMOTBD

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 63110)

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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: 1456599141View full group profile
NameSpecialtyState
Sports Medicine, Emergency MedicineMO
-FL
-MO
Physical Medicine And RehabilitationMO

Reviews

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Frequently asked questions

Is RAQUEL K RUSSO (PA-C) listed with a National Provider Identifier?
Yes — RAQUEL K RUSSO (PA-C) has NPI 1013545607 on file in the registry.
Is there an active status for RAQUEL K RUSSO (PA-C)?
For scheduling context, RAQUEL K RUSSO (PA-C) is shown as active in the registry.
What area of care is associated with RAQUEL K RUSSO (PA-C)?
RAQUEL K RUSSO (PA-C)'s record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
Is RAQUEL K RUSSO (PA-C) located near Saint Louis?
RAQUEL K RUSSO (PA-C) currently maps to Saint Louis, Missouri in this extract.
Does RAQUEL K RUSSO (PA-C) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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