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MARY TYNER
NPI 1366053969
Counselor - Mental Health in La Vista, NE

Active since August 17, 2020PECOS Enrolled
10748 VIRGINIA PLZ STE 107, LA VISTA, NE 68128(402) 933-4411(888) 507-5931 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 9, 2026, Oct 6, 2023, Aug 17, 2020 (3 updates tracked since 2020).

About Mary Tyner NPPES

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

MARY TYNER (NPI 1366053969) is an individual mental health provider in La Vista, Nebraska, licensed in Nebraska (4463) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1366053969
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMARY TYNER
Location Address10748 VIRGINIA PLZ STE 107La Vista, NE 68128-3265
Mailing Address2205 Lucille DrBellevue, NE 68147-2504 · (402) 686-9760
Phone(402) 933-4411
Fax(888) 507-5931
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateAugust 17, 2020
Last NPPES UpdateMarch 9, 20263 updates tracked since enumeration
NPPES CertifiedMarch 9, 2026
✔ NPI 1366053969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NE · 4463
Also ListedBehavior TechnicianTaxonomy 106S00000X
10748 VIRGINIA PLZ STE 107, La Vista, NE 68128
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Tyner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6103382817
PECOS Enrollment IDI20260731003954
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 Reassignment

Medicare enrollment records show Mary Tyner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Focus C3, PC
Same address
Mental Health
10748 VIRGINIA PLZ, SUITE 107
La Vista, NE 68128
  • Reassigned Medicare billing, Nebraska enrollment
  • 24 clinicians in this Medicare group
NPI 1831643964 (402) 933-4411

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

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

ERIN M WILLIAMS LIMP
Counselor (Mental Health)
10748 VIRGINIA PLZ STE 107
LA VISTA, NE 68128
Sarpy County (402) 933-4411

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 Tyner's NPI number?

The NPI number for Mary Tyner is 1366053969. It was assigned to this individual provider in the NPPES registry on August 17, 2020.

Where is Mary Tyner located?

Mary Tyner practices at 10748 Virginia Plz Ste 107, La Vista, NE 68128. The listed phone number is (402) 933-4411.

What is Mary Tyner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Mary Tyner enrolled in Medicare?

Yes. Mary Tyner is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Tyner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Tyner reassigns Medicare benefits to Focus C3, PC (La Vista, NE). 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 Tyner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mary Tyner accept?

Health plans from Oscar Insurance Company and UnitedHealthcare list Mary Tyner 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 Tyner was last updated on March 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.