NPIMap

Individual provider Active NPI

Mary Theresa Massary, M.D.

  • Family Medicine Physician
  • Bentonville, AR
National Provider Identifier
1689085680
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-18636 Issued in AR
Practice address
701 SW Regional Airport Blvd
Bentonville, AR 72713-4589
Phone
(479) 464-5590
Fax
(479) 464-5591
NPI assigned
May 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2017-01285 NC
Family Medicine Physician 207Q00000X E-18636 AR Primary

Addresses

Primary practice location

701 SW Regional Airport Blvd
Bentonville, AR 72713-4589

Mailing address

PO Box 1523
Fayetteville, AR 72702-1523
Phone (479) 571-6038

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mary.massary@mana.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171025002099 NC Practitioner - Family Practice 8123345444
I20250711003971 AR Practitioner - Family Practice 8123345444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

701 SW Regional Airport Blvd
Bentonville, AR 72713-4589
Phone (479) 464-5590

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-18636ARMDFamily Medicine Physician
2017-01285NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Northwest Arkansas PA Family Medicine CurrentSince Jul 15, 2025 Accepting new patients
Medical Associates of Northwest Arkansas, PA Family Medicine Current Accepting new patients
Medical Associates of Northwest Arkansas PA CurrentSince Jul 15, 2025 Accepting new patients
Medical Associates of Northwest Arkansas PA Family Medicine Past Accepting new patients
Medical Associates of Northwest Arkansas PA Family Medicine Past Accepting new patients
Medical Associates of Northwest Arkansas PA Family Medicine Past Accepting new patients

Locations

701 SW Regional Airport Blvd
Bentonville, AR 72713
Phone (479) 268-7640

3344 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 582-7213

Interoperability endpoints

  • Direct secure messaging: mary.massary@mana.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Circle of LifeSpringdale, AR, CCN 041529 Hospice Contracted Managing Employee Jun 1, 2026

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1689085680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1523",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021523",
            "telephone_number": "479-571-6038",
            "fax_number": "479-582-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SW REGIONAL AIRPORT BLVD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727134589",
            "telephone_number": "479-464-5590",
            "fax_number": "479-464-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSARY",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2017-01285",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-18636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mary.massary@mana.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Provider's direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "701 SW Regional Airport Blvd",
            "city": "Bentonville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727134589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.