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

Individual provider Physician Assistant · NPI 1619496999

Ruby Loretta Russell, PA-C is a Physician Assistant in Glendale, Arizona. Qualified in 2017, 9 years ago. Practices with Vhs Outpatient Clinics Inc, a 206-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2017
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

18700 N 64th Dr Ste 301
Glendale, AZ 85308-7114
Phone: (602) 841-0741
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1111 E McDowell Rd, Phoenix, AZ 85006-2612 — (602) 839-2000
  • 9201 W Thomas Rd, Phoenix, AZ 85037-3332 — (623) 327-4000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (CA)

Record details

NPI number1619496999
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 18, 2017
Last updated in NPPESJuly 13, 2024
Certification dateJuly 13, 2024
Mailing address18700 N 64th Dr Ste 301, Glendale, AZ 85308-7114

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Vhs Outpatient Clinics Inc — 206 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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