Dorothy A Tracey Rusin, PH D

Individual provider Active NPI Clinical Psychologist · Boyds, MD

NPI 1528154358 · NPPES record last updated Aug 6, 2026

Key facts

NPI
1528154358
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
925 (MD)
Practice address
20001 Bucklodge Rd
Boyds, MD 20841-9600
Phone
(240) 731-7431
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

Medicare Care Compare profile

Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9077 Shady Grove CT
Gaithersburg, MD 20877-1301
Phone (301) 977-0150

Medicare participation

Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100419000716 DC Practitioner - Clinical Psychologist 5294862538 Practice locations: Gaithersburg, MD

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
925MDMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 925 MD Yes

Addresses

Primary practice location

20001 Bucklodge Rd
Boyds, MD 20841-9600

Mailing address

20001 Bucklodge Rd
Boyds, MD 20841-9600
Phone (240) 731-7431

Other providers in Boyds, MD

All providers in Boyds, MD · Clinical Psychologist in Maryland

Sources for this page

Verify at the official NPI Registry.