Active NPI
Russel Joseph Roberts, PHARM.D., FCCM, BCCC
- Critical Care Pharmacist
- Boston, MA
National Provider Identifier
1861494312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pharmacist
- License
- PH27202
- Practice address
- 55 Fruit St
GRB-005
Boston, MA 02114-2621 - Phone
- (314) 346-7877
- NPI assigned
- Aug 15, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 2003000294 | MO | |
| Critical Care Pharmacist | 1835C0205X | PH27202 | MA | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | PH27202 | MA | |
| Pharmacotherapy Pharmacist | 1835P1200X | PH27202 | MA | |
| Critical Care Pharmacist | 1835C0205X | 2003000294 | MO | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 2003000294 | MO |
Addresses
Primary practice location
55 Fruit St
GRB-005
Boston, MA 02114-2621
Mailing address
64 Durham Rd
Dedham, MA 02026-5328
Phone (314) 346-7877
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH27202 | MA | MD | Critical Care Pharmacist |
| 2003000294 | MO | MD | Critical Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470268800000",
"number": "1861494312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 DURHAM RD",
"city": "DEDHAM",
"state": "MA",
"postal_code": "020265328",
"telephone_number": "314-346-7877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"address_2": "GRB-005",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "314-346-7877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "RUSSEL",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PHARM.D., FCCM, BCCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-15",
"last_updated": "2016-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MO",
"license": "2003000294",
"primary": false
},
{
"code": "1835C0205X",
"taxonomy_group": "",
"desc": "Pharmacist, Critical Care",
"state": "MA",
"license": "PH27202",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MA",
"license": "PH27202",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MA",
"license": "PH27202",
"primary": false
},
{
"code": "1835C0205X",
"taxonomy_group": "",
"desc": "Pharmacist, Critical Care",
"state": "MO",
"license": "2003000294",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MO",
"license": "2003000294",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.