DR. MARY E LYSTER (MD) – Family Medicine Physician, NPI 1790715654
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
406 FAMILY PRACTICE in RI
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Provider Addresses for DR. MARY E LYSTER (MD)
4533, South County Trail, Fort Ninigret, Charlestown, South County, Rhode Island, 02813, United States
CHARLESTOWN, RI 028133428
Phone: (401) 364-1268
Fax: (401) 364-6427
Type: Mailing
2000 DIAMOND HILL RD STE 18
WOONSOCKET, RI 028951554
Phone: (401) 470-7116
Fax: (401) 386-2462
Type: Location
PO BOX 746088
ATLANTA, GA 303746088
Phone: (312) 733-9730
Fax: (773) 866-8014
Type: Mailing
128 ROUTE 27
RAYMOND, NH 030771220
Phone: (603) 883-1626
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: 2004-06-24
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 |
|---|---|---|---|---|
| I20040624000027 | I | Family Practice | RI | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02813)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NH | |
| Nurse Practitioner | NH | |
| Nurse Practitioner | NH | |
| Nurse Practitioner | NH | |
| Nurse Practitioner | NH | |
| Nurse Practitioner | NH | |
| Nurse Practitioner | NH | |
| Physician Assistant | NH | |
| Nurse Practitioner | MA | |
| Clinical Social Worker | NH |
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