Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Daniel Stakutis

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1558156802

Mr. Daniel Stakutis is a Nurse Practitioner in Medford, Massachusetts. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Massachusetts.

Years since qualifying
1
Licensed in
MA
In the registry since
2025

Practice location Address checks out

100 Rivers Edge Dr Unit 448
Medford, MA 02155-5477
Phone: (508) 380-2208
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 2312263 (MA)

Record details

NPI number1558156802
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 9, 2025
Last updated in NPPESApril 9, 2025
Certification dateApril 9, 2025
Mailing address100 Rivers Edge Dr Unit 448, Medford, MA 02155-5477

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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