DR. ROBERT GERARD DELLO RUSSO PH.D., LADC I
NPI 1609867670
Psychologist - Addiction (Substance Use Disorder) in Boston, MA

Q: What is Robert Dello Russo's NPI number?

The NPI number for Robert Dello Russo is 1609867670. It was assigned to this individual provider in the NPPES registry on October 31, 2005.

Q: What is Robert Dello Russo's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Addiction (Substance Use Disorder), with taxonomy code 103TA0400X.

Active since October 31, 2005PECOS EnrolledAccepts Medicare Assignment

109 WARREN AVE, BOSTON, MA 02116(617) 484-4146 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 13, 2026, Sep 11, 2025 (2 updates tracked since 2025).

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About Dr. Robert Gerard Dello Russo Ph.d., Ladc I NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ROBERT GERARD DELLO RUSSO PH.D., LADC I (NPI 1609867670) is an individual addiction (substance use disorder) provider in Boston, Massachusetts and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1981).

NPPES Registry Identity

NPI1609867670

Entity TypeIndividualMale

Primary Taxonomy103TA0400X

Provider Legal NameDR. ROBERT GERARD DELLO RUSSOCredential: PH.D., LADC I

Location Address109 WARREN AVEBoston, MA 02116-6103

Mailing Address109 Warren AveBoston, MA 02116-6103 · (617) 484-4146

Phone(617) 484-4146

Sole ProprietorNo

Medical School CMSOtherGraduated 1981

Enumeration DateOctober 31, 2005

Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration

✔ NPI 1609867670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code103TA0400X

Definition

A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 2943 (MA)

109 WARREN AVE, Boston, MA 02116

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Robert Gerard Dello Russo Ph.d., Ladc I is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729093307

PECOS Enrollment IDI20060220000002

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Robert Dello Russo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Charles Mental Health Research & Training Foundation, Inc

4.8 mi

Psychologist

54 WASHBURN AVE
Cambridge, MA 02140

Reassigned Medicare billing, Massachusetts enrollment
7 clinicians in this Medicare group

NPI 1356411862 (617) 864-0941

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Robert Dello Russo's NPI number?

The NPI number for Robert Dello Russo is 1609867670. It was assigned to this individual provider in the NPPES registry on October 31, 2005.

Where is Robert Dello Russo located?

Robert Dello Russo practices at 109 Warren Ave, Boston, MA 02116. The listed phone number is (617) 484-4146.

What is Robert Dello Russo's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Addiction (Substance Use Disorder), with taxonomy code 103TA0400X.

Is Robert Dello Russo enrolled in Medicare?

Yes. Robert Dello Russo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Robert Dello Russo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Robert Dello Russo reassigns Medicare benefits to North Charles Mental Health Research & Training Foundation, Inc (Cambridge, MA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Robert Dello Russo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Robert Dello Russo was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.