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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. GARY J RUSSELL MD
NPI 1669463550
Pediatrics - Pediatric Gastroenterology in Boston, MA

Active since October 31, 2005PECOS Enrolled
55 FRUIT ST, YAW 6, BOSTON, MA 02114(617) 726-8705(617) 724-2710 Get Directions Write a Review

NPPES record last updated: June 28, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Gary J Russell Md NPPES

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

DR. GARY J RUSSELL MD (NPI 1669463550) is an individual pediatric gastroenterology provider in Boston, Massachusetts, licensed in Massachusetts (57051) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669463550
Entity TypeIndividualMale
Primary Taxonomy2080P0206X
Provider Legal NameDR. GARY J RUSSELLCredential: MD
Location Address55 FRUIT ST, YAW 6Boston, MA 02114-2621
Mailing AddressPo Box 9142Charlestown, MA 02129-9142 · (617) 726-8705 · Fax (617) 724-2710
Phone(617) 726-8705
Fax(617) 724-2710
Sole ProprietorNo
Enumeration DateOctober 31, 2005
Last NPPES UpdateJune 28, 2026
✔ NPI 1669463550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0206X
License✔ Licensed in MA · 57051
Definition
A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.
Also ListedPediatricsTaxonomy 208000000X · License 57051 (MA)
55 FRUIT ST, Boston, MA 02114
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Other Identifiers 3

Medicaid3036430MA
Other057051MA · Tufts Health Plan
OtherJ07673MA · Bcbs Ma

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Gary J Russell Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STUTI GIRISH SHROFF MD, MBBS
Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2971
NANCY WANG M.D.
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (017) 724-4000
DR. DUSAN HANIDZIAR M.D., PH.D.
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Suffolk County (617) 726-3030
JOHN JOSEPH DANKO DO
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2000
DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Suffolk County (617) 724-9248
MS. KELLY ELISHA TRECARTIN NP
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Suffolk County (617) 726-7400
JAMIE MARIE ALLEN NP
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 724-4410
DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 643-3238

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 Gary Russell's NPI number?

The NPI number for Gary Russell is 1669463550. It was assigned to this individual provider in the NPPES registry on October 31, 2005.

Where is Gary Russell located?

Gary Russell practices at 55 Fruit St Yaw 6, Boston, MA 02114. The listed phone number is (617) 726-8705.

What is Gary Russell's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.

Is Gary Russell enrolled in Medicare?

Yes. Gary Russell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Gary Russell was last updated on June 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 44 days 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.