LYSSA MERRIAM PETTER (MS,RD,LDN) – Registered Dietitian, NPI 1710086277

LYSSA MERRIAM PETTER (MS,RD,LDN) is a healthcare provider. based in Andover, Massachusetts. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials MS,RD,LDN. They hold a License No. 826 (MA). The NPI Number for LYSSA MERRIAM PETTER (MS,RD,LDN) is 1710086277

Main info

Female
39 Years Of Experience
Name
LYSSA MERRIAM PETTER (MS,RD,LDN)
NPI
1710086277
Phone
(978) 687-0156
Address
13 PINECREST RD
Enumeration Date
21 September 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7744092009
Graduation Year
1987 (39 years ago)
PAC ID
7911943816
Group Practice PAC ID
3870020399
Professional Enrollment ID
I20050630000656
Address ID
MA027801086TA2007XSTXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

247 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in MA

Provider Addresses for LYSSA MERRIAM PETTER (MS,RD,LDN)

  • 13, Pinecrest Road, Andover, Essex County, Massachusetts, 01885, United States

    ANDOVER, MA 018105712

    Phone: (978) 687-0156

    Fax: (978) 681-9075

    Type: Mailing

  • CARITAS HOLY FAMILY HOSPITAL 70 EAST STREET

    CONVENT BUILDING

    METHUEN, MA 01844

    Phone: (978) 687-0156

    Fax: (978) 681-9075

    Type: Location

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: 2005-06-30

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050630000656IRegistered Dietitian Or Nutrition ProfessionalMATBD

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 01810)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3870020399View full group profile
NameSpecialtyState
Emergency MedicineHI
Emergency MedicineNY
P S Y C H I A T R YMA
Cardiovascular Disease (Cardiology)MA
Internal MedicineMA
Occupational Therapist In Private PracticeMA
P S Y C H I A T R YMA
A N E S T H E S I O L O G YMA
Certified Registered Nurse Anesthetist (Crna)MA
Internal MedicineMA

Reviews

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Frequently asked questions

What federal number belongs to LYSSA MERRIAM PETTER (MS,RD,LDN)?
The federal identifier for LYSSA MERRIAM PETTER (MS,RD,LDN) is NPI 1710086277.
Is LYSSA MERRIAM PETTER (MS,RD,LDN) currently active in the NPI registry?
CMS-published data lists LYSSA MERRIAM PETTER (MS,RD,LDN) as an active registrant.
What does LYSSA MERRIAM PETTER (MS,RD,LDN) treat or focus on?
Patients typically see LYSSA MERRIAM PETTER (MS,RD,LDN) under the specialty Registered Dietitian. Clinical services aligned with this taxonomy classification.
Where is LYSSA MERRIAM PETTER (MS,RD,LDN)'s primary listing?
We display Andover, Massachusetts because that is what the record indicates for LYSSA MERRIAM PETTER (MS,RD,LDN).
What if Andover, Massachusetts seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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