Gerald Lee Russell, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

761 Issued in NM

Practice address

713 6TH St
Las Vegas, NM 87701-4359

Phone

(505) 429-4679

Fax

(505) 425-3370

NPI assigned

Aug 11, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• High Plains Neuropsychology Associates PC

  • Clinical Neuropsychologist
  • Las Vegas, NM
  • NPI 1780916130
  Authorized official Same address or phone
• Pueblo of Isleta

  dba Pueblof of Isleta EMS

  • Ambulance
  • Isleta, NM
  • NPI 1023191368
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1326040148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877011705",
            "telephone_number": "505-454-2202",
            "fax_number": "505-454-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 6TH ST",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014359",
            "telephone_number": "505-429-4679",
            "fax_number": "505-425-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "GERALD",
        "middle_name": "LEE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NM",
            "license": "761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76705",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deanna L Roybal
• Ann Bosley Ruge, CNM
• Chris B. Ruge, APRN, BC
• Monica Ruiz-Marquez
• Rural Surgical Associates of Las Vegas LLC
• Robert F. Rutschman, M.D.
• Ryan K Anderson D P M P C (Foot and Ankle Specialists of Northern New Mexico)
• David Saiz, RPH
• Rosann Saiz
• Paulina Jean Salas

• Clinical Neuropsychologist in Las Vegas, NM
• Providers in Las Vegas, NM by specialty
• Clinical Neuropsychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.