ADAM RUSSELL – Physician Assistant, NPI 1063247583

ADAM RUSSELL is a healthcare provider. based in Henderson, Nevada. specializing in PHYSICIAN ASSISTANT. The NPI Number for ADAM RUSSELL is 1063247583

Main info

Male
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
ADAM RUSSELL
NPI
1063247583
Phone
(801) 900-3051
Address
650 PACIFIC CASCADES DR
Enumeration Date
4 September 2024
Last Update Date
4 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4358432000
Graduation Year
2024 (2 years ago)
PAC ID
5395265904
Group Practice PAC ID
6305260746
Professional Enrollment ID
I20250226002895
Address ID
UT840749280TO85XXX2000300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

1,223 PHYSICIAN ASSISTANT in NV

Provider Addresses for ADAM RUSSELL

  • 650 PACIFIC CASCADES DR

    HENDERSON, NV 890125669

    Phone: (801) 900-3051

    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: 2025-02-26

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
I20250226002895IPhysician AssistantUTTBD

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 89012)

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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: 6305260746View full group profile
NameSpecialtyState
Family PracticeUT
Nurse PractitionerCO
Internal Medicine, HospitalistUT
Physician AssistantKS
Family PracticeWY
Physician AssistantWY
Nurse PractitionerUT
P O D I A T R YUT
Nurse PractitionerWY
Nurse PractitionerUT

Reviews

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Frequently asked questions

Is there an official ID for ADAM RUSSELL in U.S. healthcare records?
The official identifier for ADAM RUSSELL is NPI 1063247583.
Active or inactive — what applies to ADAM RUSSELL?
You should see ADAM RUSSELL as active in CMS-hosted NPPES data.
What expertise is attributed to ADAM RUSSELL?
ADAM RUSSELL's specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
Is ADAM RUSSELL associated with Henderson?
Public fields place ADAM RUSSELL around Henderson, Nevada. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for ADAM RUSSELL is noted as September 4, 2024 where the registry provides it.

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