MARY POULIAS MITCHELL (NP-C) – Family Nurse Practitioner, NPI 1639628753
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,971 NURSE PRACTITIONER in MA
Provider Addresses for MARY POULIAS MITCHELL (NP-C)
64 BOYDEN RD
HOLDEN, MA 015202570
Phone: (508) 829-6765
Fax: (978) 840-1680
Type: Location
Grace Riley Aesthetics
409 Shrewsbury Street
worcester, MA 01604
Phone: (508) 508-7965
Fax: (833) 635-6680
Type: Location
Lifetime Center For Family Health, 165, Mill Street, Leominster, Worcester County, Massachusetts, 01453, United States
LEOMINSTER, MA 014533289
Phone: (978) 468-3208
Fax: (978) 840-1680
Type: Location
5, Neponset Street, Worcester, Worcester County, Massachusetts, 01606, United States
WORCESTER, MA 016062714
Phone: (508) 368-5532
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $156.
Total Amount is formed as General ($156) + Research ($0) + Ownership ($0) = $156.
Last reported payment date: 2024-03-04 • Largest payer in this snapshot: REVANCE THERAPEUTICS, INC. ($156).
Total Amount
$156
General + Research + Ownership
Payments
1
Total payment records
General Amount
$156
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| REVANCE THERAPEUTICS, INC. | $156 |
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: 2016-12-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20161230000099 | I | Nurse Practitioner | MA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 94 | 71 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 17 | 17 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 16 | 16 | $0 |
Insurance plans in this area (ZIP 01520)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | MA | |
| Internal Medicine | MA | |
| - | MA | |
| - | MA | |
| Emergency Medicine | MA | |
| Physical Therapist In Private Practice | MA | |
| Physician Assistant | MA | |
| Family Practice | MA | |
| Clinical Psychologist | MA | |
| - | MA |
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