DR. CYNTHIA S. TAVILLA (PSY.D.) – Clinical Psychologist, NPI 1104816164

DR. CYNTHIA S. TAVILLA (PSY.D.) is a healthcare provider. based in Lexington, Massachusetts. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D.. They hold a License No. 7549 (MA). The NPI Number for DR. CYNTHIA S. TAVILLA (PSY.D.) is 1104816164

Main info

Female
Sole Proprietor
29 Years Of Experience
Accepts Medicare Assignment
Name
DR. CYNTHIA S. TAVILLA (PSY.D.)
NPI
1104816164
Phone
(781) 863-5570
Address
9 MERIAM ST
Enumeration Date
21 October 2005
Last Update Date
6 May 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7818635570
Graduation Year
1997 (29 years ago)
PAC ID
1153510227
Professional Enrollment ID
I20110105001201
Address ID
MA024205312LE9XXXXSTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,694 CLINICAL PSYCHOLOGIST in MA

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Provider Addresses for DR. CYNTHIA S. TAVILLA (PSY.D.)

  • 9, Meriam Street, Lexington, Middlesex County, Massachusetts, 02420, United States

    . SUITE 25

    LEXINGTON, MA 024205300

    Phone: (781) 863-5570

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-01-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110105001201IClinical PsychologistMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02420)

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Reviews

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Frequently asked questions

How is DR. CYNTHIA S. TAVILLA (PSY.D.) identified in CMS data?
CMS-hosted NPPES data lists DR. CYNTHIA S. TAVILLA (PSY.D.) with NPI 1104816164.
Does the file indicate DR. CYNTHIA S. TAVILLA (PSY.D.) is practicing under active NPI?
Directory data currently reports DR. CYNTHIA S. TAVILLA (PSY.D.) as active.
What is DR. CYNTHIA S. TAVILLA (PSY.D.)'s primary classification?
Clinical Psychologist is the headline specialty for DR. CYNTHIA S. TAVILLA (PSY.D.) here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. CYNTHIA S. TAVILLA (PSY.D.)?
DR. CYNTHIA S. TAVILLA (PSY.D.)'s geographic hint is Lexington, Massachusetts in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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