MARA LORIS NYDES (MD) – Sports Medicine (Family Medicine) Physician, NPI 1255824603
Sports Medicine (Family Medicine) Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MARA LORIS NYDES (MD)
322 W NORTH RIVER DR
SPOKANE, WA 992013208
Phone: (509) 324-6464
Fax: (509) 241-2056
Type: Mailing
Mott Children's Hospital and Von Voigtlander Women's Hospital, 1500, East Medical Center Drive, Ann Arbor, Washtenaw County, Michigan, 48109, United States
D-3230
ANN ARBOR, MI 48109
Phone: (734) 763-9251
Type: Mailing
15 E Chestnut St
Augusta, ME 043305736
Phone: (207) 623-6663
Type: Location
1500 East Medical Center Drive
D-3230
Ann Arbor, MI 48109
Phone: (734) 763-9251
Type: Location
15 E CHESTNUT ST
AUGUSTA, ME 043305736
Phone: (207) 623-6663
Type: Mailing
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: 2023-03-29
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230329001354 | I | Sports Medicine | WA | 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 |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 66 | 14 | $0 |
Insurance plans in this area (ZIP 99201)
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