NPIMap

Organization Active NPI

Daniel Rutrick MD PC

  • Adult Psychiatric/Mental Health Registered Nurse
  • Everett, MA
National Provider Identifier
1851500151
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
164216 Issued in MA
Legal business name
DANIEL RUTRICK MD PC
Practice address
617 Broadway
Everett, MA 02149-3712
Phone
(617) 387-2220
Fax
(617) 394-0538
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Eileen McClellan, OFFICE MANAGER
Title
Office Manger
Phone
(617) 387-2220

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 2351 MA
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X 8277 MA
Adult Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0809X 142070 MA
Adult Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0809X 164216 MA Primary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X 36462 MA

Addresses

Primary practice location

617 Broadway
Everett, MA 02149-3712

Mailing address

617 Broadway
Everett, MA 02149-3712
Phone (617) 387-2220

Other identifiers 4

IdentifierTypeStateIssuer
036462OtherMDTUFTS GROUP NUMBER
500019OtherMARUTRICK GROUP PSYCHOLOGIS
50064OtherMATUFTS CERTIFIED NURSE SPE
M13835OtherMABLUE SHIELD GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

617 Broadway
Everett, MA 02149
Phone (617) 387-2220

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1851500151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 BROADWAY",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493712",
            "telephone_number": "617-387-2220",
            "fax_number": "617-394-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 BROADWAY",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493712",
            "telephone_number": "617-387-2220",
            "fax_number": "617-394-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL RUTRICK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "OFFICE MANGER",
        "authorized_official_telephone_number": "617-387-2220",
        "authorized_official_credential": "OFFICE MANAGER"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MA",
            "license": "2351",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "8277",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "142070",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "164216",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MA",
            "license": "36462",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS GROUP NUMBER",
            "identifier": "036462",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RUTRICK GROUP PSYCHOLOGIS",
            "identifier": "500019",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS CERTIFIED NURSE SPE",
            "identifier": "50064",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP NUMBER",
            "identifier": "M13835",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.