MARY KACKLEY
NPI 1285241554
Nurse Practitioner in Washington, DC
About Mary Kackley NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY KACKLEY (NPI 1285241554) is an individual nurse practitioner in Washington, District Of Columbia, licensed in District Of Columbia (NP1039064) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
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 Kackley 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 Reassignment
Medicare enrollment records show Mary Kackley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Baltimore, MD 21287
- Reassigned Medicare billing, District of Columbia enrollment
- 72 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 20016 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WASHINGTON, DC 20016
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 Kackley's NPI number?
The NPI number for Mary Kackley is 1285241554. It was assigned to this individual provider in the NPPES registry on September 30, 2020.
Where is Mary Kackley located?
Mary Kackley practices at 5255 Loughboro Rd NW, Washington, DC 20016. The listed phone number is (202) 537-4000.
What is Mary Kackley's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Mary Kackley enrolled in Medicare?
Yes. Mary Kackley 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 organization bills Medicare for Mary Kackley's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Kackley reassigns Medicare benefits to Johns Hopkins University (Baltimore, MD). The 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 Kackley'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 Mary Kackley was last updated on July 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Mary Kackley · NPI 1285241554
Nurse Practitioner physician in Washington, District of Columbia. Individual provider, active in the CMS NPPES registry since September 30, 2020.
## Identity
- **NPI:** 1285241554 (Entity type: Individual)
- **Enumerated:** September 30, 2020
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** NP1039064 (District of Columbia)
- **Sole proprietor:** No
## Practice location
- **Address:** 5255 LOUGHBORO RD NW, Washington, DC 20016-2633
- **Phone:** (202) 537-4000 · **Fax:** (202) 537-4588
## 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:** Johns Hopkins University (NPI 1902896970, Baltimore, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** July 21, 2025
- **Other identifiers:** Other 0024180229 (VA)
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Source: [NPI Profile](https://npiprofile.com/npi/1285241554) · Data from the CMS NPPES public registry.