1. Home
  2. Directory
  3. Ohio
  4. Upper Arlington
  5. Psychologist
  6. NPI Profile

SARA BOURNE LACY PSY.D.
NPI 1619341468
Psychologist - Clinical in Upper Arlington, OH

Active since November 17, 2015PECOS Enrolled
95.31/100
CMS Quality Rating
3200 TREMONT RD, UPPER ARLINGTON, OH 43221(614) 293-9777(614) 293-9677 Get Directions Write a Review

NPPES record last updated: February 10, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 10, 2025, Dec 10, 2024, Dec 17, 2020 and 3 more (6 updates tracked since 2015).

About Sara Bourne Lacy Psy.d. NPPES

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

SARA BOURNE LACY PSY.D. (NPI 1619341468) is an individual clinical provider in Upper Arlington, Ohio, licensed in Ohio (P.7380) and active in the NPI registry since November 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Columbus.

NPPES Registry Identity

NPI1619341468
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameSARA BOURNE LACYCredential: PSY.D.
Location Address3200 TREMONT RDUpper Arlington, OH 43221-2040
Mailing Address700 Ackerman Rd Ste 2120Columbus, OH 43202-1559 · (614) 293-9777 · Fax (614) 293-9677
Phone(614) 293-9777
Fax(614) 293-9677
Sole ProprietorNo
Enumeration DateNovember 17, 2015
Last NPPES UpdateFebruary 10, 20256 updates tracked since enumeration
NPPES CertifiedFebruary 10, 2025
✔ NPI 1619341468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in OH · P.7380
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
3200 TREMONT RD, Upper Arlington, OH 43221
Open in Google Maps ↗

Secondary Practice Location 1

Location 12000 Kenny RdColumbus, OH 43221-3555 · Phone (614) 293-5123 · Fax (614) 293-4980

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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 (PECOS)

Sara Bourne Lacy Psy.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Sara Lacy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Osu General Internal Medicine LLC
0.2 mi
Internal Medicine
1800 ZOLLINGER RD
Columbus, OH 43221
  • Reassigned Medicare billing, Ohio enrollment
  • 303 clinicians in this Medicare group
NPI 1689919599 (614) 293-5123

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 43221 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
$166.65 typical visit price
range $54.34 – $166.65
Typical copayment $41.66 (range $13.58 – $41.66)
Most-billed visit code 99205
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.58
Promoting Interoperability100
Improvement Activities40

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.

SHIMBOON YOON L.AC.
Acupuncturist
3200 TREMONT RD
UPPER ARLINGTON, OH 43221
Franklin County (614) 293-9777
ANNIE TRANCE LISW
Counselor (Professional)
3200 TREMONT RD
UPPER ARLINGTON, OH 43221
Franklin County (614) 366-8700
MEHROSH NASEEM MD
Family Medicine
3200 TREMONT RD
UPPER ARLINGTON, OH 43221
Franklin County (614) 293-9777
DR. ERICA YUMI YAMAMOTO DO
Family Medicine
3200 TREMONT RD
UPPER ARLINGTON, OH 43221
Franklin County (614) 293-9777
AMY E. THOMPSON APRN-CNP, MSN
Nurse Practitioner (Psychiatric/Mental Health)
3200 TREMONT RD
UPPER ARLINGTON, OH 43221
Franklin County (614) 366-8700
JORDAN WADDELL APRN-CNP
Nurse Practitioner
3200 TREMONT RD
UPPER ARLINGTON, OH 43221
Franklin County (614) 293-9777
JESSICA L HENNING APRN-CNP
Nurse Practitioner
3200 TREMONT RD
UPPER ARLINGTON, OH 43221
Franklin County (614) 293-9777
MS. MICHELLE SAUBERZWEIG LA.C
Acupuncturist
3200 TREMONT RD
UPPER ARLINGTON, OH 43221
Franklin County (614) 293-9777

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 Sara Lacy's NPI number?

The NPI number for Sara Lacy is 1619341468. It was assigned to this individual provider in the NPPES registry on November 17, 2015.

Where is Sara Lacy located?

Sara Lacy practices at 3200 Tremont Rd, Upper Arlington, OH 43221. The listed phone number is (614) 293-9777.

What is Sara Lacy's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Sara Lacy enrolled in Medicare?

Yes. Sara Lacy is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Sara Lacy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sara Lacy reassigns Medicare benefits to Osu General Internal Medicine LLC (Columbus, OH). 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 Sara Lacy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sara Lacy accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Antidote Health Plan of Ohio, Inc. and 4 other insurers list Sara 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 Sara Lacy was last updated on February 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.