Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Catherine Russo, PA-C

Individual provider Physician Assistant · NPI 1144006834

Catherine Russo, PA-C is a Physician Assistant in Salt Lake City, Utah. Qualified in 2023, 3 years ago. Practices with Granger Medical Clinic PC, a 191-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
3
Licensed in
UT
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4252 S Highland Dr Ste 200
Salt Lake City, UT 84124-2690
Phone: (801) 993-1800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 13502894-1206 (UT)
Physician Assistant Taxonomy 363A00000X · Licence 13502894-1206 (UT)

Record details

NPI number1144006834
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 7, 2023
Last updated in NPPESJanuary 23, 2025
Certification dateJanuary 23, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Granger Medical Clinic Pc — 191 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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