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MARY J LACY NP
NPI 1093701781
Nurse Practitioner - Family in Marietta, GA

Active since September 27, 2005PECOS EnrolledAccepts Medicare Assignment
310 KENNESTONE HOSPITAL BLVD, MARIETTA, GA 30060(770) 793-7856(770) 793-7856 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mary J Lacy Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY J LACY NP (NPI 1093701781) is an individual family provider in Marietta, Georgia, licensed in Georgia (RN131464) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS, maintains a secondary practice location in Atlanta, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1093701781
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARY J LACYCredential: NP
Location Address310 KENNESTONE HOSPITAL BLVDMarietta, GA 30060-1120
Mailing Address310 Kennestone Hospital BlvdMarietta, GA 30060-1120 · (770) 793-7856 · Fax (770) 793-7856
Phone(770) 793-7856
Fax(770) 793-7856
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateSeptember 27, 2005
Last NPPES UpdateApril 17, 2025
NPPES CertifiedApril 17, 2025
✔ NPI 1093701781 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · RN131464
310 KENNESTONE HOSPITAL BLVD, Marietta, GA 30060
Open in Google Maps ↗

Secondary Practice Location 1

Location 15670 Peachtree Dunwoody Rd, Suite 1000Atlanta, GA 30342-1699 · Phone (404) 255-1930 ext. 1156 · Fax (404) 459-8510

Other Identifiers 2

Medicaid962062906AGA
Medicaid962062906CGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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

Mary J Lacy Np 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.

PECOS PAC ID2466580568
PECOS Enrollment IDI20100511000753
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Mary Lacy reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ascend Medical Georgia II PC
18 mi
Psychiatry
619 RANKIN ST NE
Atlanta, GA 30308
  • Reassigned Medicare billing, Georgia enrollment
  • 38 clinicians in this Medicare group
NPI 1659966075 (888) 250-5708
Ascend Medical Georgia PC
18 mi
Family Medicine
619 RANKIN ST NE
Atlanta, GA 30308
  • Reassigned Medicare billing, Georgia enrollment
  • 40 clinicians in this Medicare group
NPI 1841800836 (888) 250-5708

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 30060 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NOKUTHULA NONDUMISO MSIMANGA MD
Family Medicine (Hospice and Palliative Medicine)
310 KENNESTONE HOSPITAL BLVD
MARIETTA, GA 30060
Cobb County (770) 793-7899
CHRISTY NELSON FNP
Nurse Practitioner (Family)
310 KENNESTONE HOSPITAL BLVD
MARIETTA, GA 30060
Cobb County (877) 354-1821
CHRISTINA CHEN MD
Internal Medicine (Hospice and Palliative Medicine)
310 KENNESTONE HOSPITAL BLVD
MARIETTA, GA 30060
Cobb County (843) 577-5011
NIKHITA ANANTHULA MD
Internal Medicine (Hospice and Palliative Medicine)
310 KENNESTONE HOSPITAL BLVD
MARIETTA, GA 30060
Cobb County (770) 793-7899
DR. ROSSITZA IORDANOVA M.D.
Emergency Medicine (Hospice and Palliative Medicine)
310 KENNESTONE HOSPITAL BLVD
MARIETTA, GA 30060
Cobb County (770) 793-7899
NEDRA HEATH APRN
Nurse Practitioner (Adult Health)
310 KENNESTONE HOSPITAL BLVD
MARIETTA, GA 30060
Cobb County (770) 793-7902
MELISSA M. SCHEPP M.D.
Internal Medicine (Hospice and Palliative Medicine)
310 KENNESTONE HOSPITAL BLVD
MARIETTA, GA 30060
Cobb County (770) 793-7899
DR. SAMINA AFTAB CHOUDHRY M.D.
Family Medicine (Hospice and Palliative Medicine)
310 KENNESTONE HOSPITAL BLVD
MARIETTA, GA 30060
Cobb County (770) 793-7899

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 Mary Lacy's NPI number?

The NPI number for Mary Lacy is 1093701781. It was assigned to this individual provider in the NPPES registry on September 27, 2005.

Where is Mary Lacy located?

Mary Lacy practices at 310 Kennestone Hospital Blvd, Marietta, GA 30060. The listed phone number is (770) 793-7856.

What is Mary Lacy's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mary Lacy enrolled in Medicare?

Yes. Mary Lacy 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 Mary Lacy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Lacy reassigns Medicare benefits to 2 organizations: Ascend Medical Georgia II PC (Atlanta, GA) and Ascend Medical Georgia PC (Atlanta, GA). 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 Mary Lacy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mary Lacy accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Mary Lacy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Lacy was last updated on April 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.