Individual provider Active NPI

Gregory Christopher Russo, MD

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1912693565
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1026071 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(617) 724-3874
NPI assigned
Apr 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1026071 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

55 Fruit St
Blake 1500 Hmu
Boston, MA 02114-2696
Phone (585) 756-4800

Other practice location 1

990 South Ave Ste 207
Rochester, NY 14620-2762
Phone (585) 341-6775

Other practice location 2

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 756-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230707000875 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0143689216

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

399 Revolution Dr
Somerville, MA 02145-1444

399 Revolution Dr
Suite 580
Somerville, MA 02145-1572

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1026071MAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1912693565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "BLAKE 1500 HMU",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "585-756-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-724-3874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "990 South Ave Ste 207",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146202762",
            "country_code": "US",
            "telephone_number": "585-341-6775",
            "fax_number": "585-341-8310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-756-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "GREGORY",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-17",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "1026071",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.