DANIEL RUTRICK M.D.
NPI 1568499242
Specialist in Watertown, MA

NPI Status: Active since June 27, 2006

Contact Information

521 MOUNT AUBURN ST STE 107-109
WATERTOWN, MA
ZIP 02472
Phone: (617) 775-1818
Fax: (617) 744-8543

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  • Individual
  • Male
  • Specialist
  • PECOS Enrolled
  • Opted-Out Medicare
  • CLIA Number: 22D2106289
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-14-2025

About DANIEL RUTRICK

This page provides the complete NPI Profile along with additional information for Daniel Rutrick, a provider established in Watertown, Massachusetts with a medical specialization in Specialist. The healthcare provider is registered in the NPI registry with number 1568499242 assigned on June 2006. The practitioner's primary taxonomy code is 174400000X with license number 36462 (MA). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1568499242
Provider Name
DANIEL RUTRICK M.D.
Gender
Male
Entity Type
Individual
Location Address
521 MOUNT AUBURN ST STE 107-109 WATERTOWN, MA 02472
Location Phone
(617) 775-1818
Location Fax
(617) 744-8543
Mailing Address
56 SOMERSET RD WEST NEWTON, MA 02465
Mailing Phone
(617) 775-1818
Mailing Fax
(617) 744-8543
Is Sole Proprietor?
No
Enumeration Date
06-27-2006
Last Update Date
01-09-2015
Code Navigator



The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Daniel Rutrick opted out of Medicare effective on 10-17-2016 until 10-17-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
36462
License State
MA
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
A33612MEDICARE UPIN (02)MA 

Medicare Participation & PECOS Enrollment Status

Daniel Rutrick is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 10-17-2016

  • Opt-Out End Date: 10-17-2026

  • Eligible to Order and Refer? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
22D2106289
Facility Type
Physician Office
Certificate Effective Date
December 15, 2023
Certificate Expiration Date
December 14, 2025
Laboratory Director
DANIEL RUTRICK
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Daniel Rutrick to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1568499242, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 78. The final step is to find the difference between that total and the next multiple of ten (80 - 78 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
8
Unchanged
Pos 5
4
Doubled → 8
Pos 6
9
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
2
Unchanged
Pos 9
4
Doubled → 8
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 4 → 8 9 → 18 → 9 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 2 + 8 + 8 + 9 + 1 + 8 + 2 + 8 + 24 = 78

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 78 is 80. The difference is the calculated check digit.

80 - 78 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1568499242.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1568499242, enumerated as an "individual" on June 27, 2006.

The provider is located at 521 MOUNT AUBURN ST STE 107-109 WATERTOWN, MA 02472 and the phone number is (617) 775-1818.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.