Individual provider Active NPI

Mali Sirisena

  • Psychiatric/Mental Health Nurse Practitioner
  • Fayetteville, AR
National Provider Identifier
1730901588
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
230741 Issued in AR
Practice address
86 W Sunbridge Dr
Fayetteville, AR 72703-1822
Phone
(479) 443-5575
NPI assigned
Oct 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 230741 AR Primary

Addresses

Primary practice location

86 W Sunbridge Dr
Fayetteville, AR 72703-1822

Mailing address

86 W Sunbridge Dr
Fayetteville, AR 72703-1822
Phone (479) 443-5575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212003892 AR Practitioner - Nurse Practitioner 8325578883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texarkana Behavioral Associates LCGroup PAC ID 9436062379, 12 clinicians

Practice addresses (Care Compare)

4253 N Crossover Rd
Fayetteville, AR 72703-4593
Phone (479) 521-5731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texarkana Behavioral Associates, L.C. CurrentSince Jan 28, 2026 Accepting new patients
Texarkana Behavioral Associates, L.C. CurrentSince Jan 28, 2026 Accepting new patients

Locations

4253 N Crossover Rd
Fayetteville, AR 72703
Phone (479) 443-6496

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1730901588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 W SUNBRIDGE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031822",
            "telephone_number": "479-443-5575",
            "fax_number": "479-443-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 W SUNBRIDGE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031822",
            "telephone_number": "479-443-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRISENA",
        "first_name": "MALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "230741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.