MALLORY JEAN LACKEY FNP
NPI 1093511982
Nurse Practitioner - Family in Fall River, MA
About Mallory Jean Lackey Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MALLORY JEAN LACKEY FNP (NPI 1093511982) is an individual family provider in Fall River, Massachusetts, licensed in Massachusetts (RN2352059) and active in the NPI registry since February 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mallory Jean Lackey Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Mallory Lackey reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Medway, MA 02053
- Reassigned Medicare billing, Massachusetts enrollment
- 186 clinicians in this Medicare group
Acton, MA 01720
- Reassigned Medicare billing, Massachusetts enrollment
- 19 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 02720 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FALL RIVER, MA 02720
FALL RIVER, MA 02720
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mallory Lackey's NPI number?
The NPI number for Mallory Lackey is 1093511982. It was assigned to this individual provider in the NPPES registry on February 20, 2025.
Where is Mallory Lackey located?
Mallory Lackey practices at 1620 President Ave, Fall River, MA 02720. The listed phone number is (508) 672-2403.
What is Mallory Lackey's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Mallory Lackey enrolled in Medicare?
Yes. Mallory Lackey is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Mallory Lackey's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mallory Lackey reassigns Medicare benefits to 2 organizations: Minuteclinic Diagnostic Of Massachusetts LLC (Medway, MA) and Jose R. Gutierrez MD PC (Acton, MA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mallory Lackey's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mallory Lackey was last updated on August 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mallory Jean Lackey, FNP · NPI 1093511982
Family physician in Fall River, Massachusetts. Individual provider, active in the CMS NPPES registry since February 20, 2025.
## Identity
- **NPI:** 1093511982 (Entity type: Individual)
- **Enumerated:** February 20, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** RN2352059 (Massachusetts)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1620 PRESIDENT AVE, Fall River, MA 02720-7148
- **Phone:** (508) 672-2403
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Minuteclinic Diagnostic Of Massachusetts LLC (NPI 1457470858, Medway, MA); Jose R. Gutierrez MD PC (NPI 1851987663, Acton, MA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** August 11, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1093511982) · Data from the CMS NPPES public registry.