MARA-LYSA ANTHONY (PSY.D.) – Psychologist, NPI 1700145638

MARA-LYSA ANTHONY (PSY.D.) is a healthcare provider. based in Arlington, Texas. specializing in Psychologist. They hold the professional credentials PSY.D.. They hold a License No. 36136 (TX). The NPI Number for MARA-LYSA ANTHONY (PSY.D.) is 1700145638

Main info

Female
Sole Proprietor
17 Years Of Experience
Accepts Medicare Assignment
Name
MARA-LYSA ANTHONY (PSY.D.)
NPI
1700145638
Phone
Not provided
Address
1006 N BOWEN RD
Enumeration Date
12 May 2012
Last Update Date
4 September 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8175330825
Graduation Year
2009 (17 years ago)
PAC ID
4183878143
Group Practice PAC ID
1951551076
Professional Enrollment ID
I20130129000506
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for MARA-LYSA ANTHONY (PSY.D.)

  • 1006 N BOWEN RD

    105

    ARLINGTON, TX 760122826

    Phone:

    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: 2013-01-29

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
I20130129000506IClinical PsychologistTXTBD

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 76012)

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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: 1951551076View full group profile
NameSpecialtyState
Clinical PsychologistTX
Clinical PsychologistTX
-TX
-TX

Reviews

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Frequently asked questions

What unique ID ties claims to MARA-LYSA ANTHONY (PSY.D.)?
NPI 1700145638 is assigned to MARA-LYSA ANTHONY (PSY.D.) under the national enumeration system.
Is MARA-LYSA ANTHONY (PSY.D.) active in the national directory?
MARA-LYSA ANTHONY (PSY.D.)'s public NPI profile is in an active state.
What field does MARA-LYSA ANTHONY (PSY.D.) work in?
You can think of MARA-LYSA ANTHONY (PSY.D.) as practicing within Psychologist. Clinical services aligned with this taxonomy classification.
What location metadata exists for MARA-LYSA ANTHONY (PSY.D.)?
The page summarizes Arlington, Texas for MARA-LYSA ANTHONY (PSY.D.); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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