Nicole M Pettibone, LMSW - Medicare Clinical Social Worker in Southfield, MI

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Nicole M Pettibone, LMSW is a medicare enrolled "Social Worker" provider in Southfield, Michigan. Her current practice location is 22255 Greenfield Rd Ste 550, Southfield, Michigan. You can reach out to her office (for appointments etc.) via phone at (844) 576-9226.

Nicole M Pettibone is licensed to practice in Michigan (license number 6801097713) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1679969752.

Contact Information

Nicole M Pettibone, LMSW
22255 Greenfield Rd Ste 550,
Southfield, MI 48075-3730
(844) 576-9226
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameNicole M Pettibone
GenderFemale
SpecialitySocial Worker
Location22255 Greenfield Rd Ste 550, Southfield, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1679969752
  • Provider Enumeration Date: 04/15/2015
  • Last Update Date: 01/20/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 0244590578
  • Enrollment ID: I20180207000465

Medical Identifiers

Medical identifiers for Nicole M Pettibone such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679969752NPI-NPPES
6801097713OtherMISTATE OF MICHIGAN - MICHIGAN DEPARTMENT OF LICENSING & REGULATORY AFFAIRS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical 6801097713 (Michigan)Secondary
104100000XSocial Worker 6801097713 (Michigan)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nicole M Pettibone allows following entities to bill medicare on her behalf.
Entity NameAscension Eastwood Behavioral Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396787701
PECOS PAC ID: 2163324492
Enrollment ID: O20040126000572
Entity NameRichard Kneip, Ph.d., P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1679739700
PECOS PAC ID: 4880768415
Enrollment ID: O20080731000086
Entity NameThe Guidance Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609947027
PECOS PAC ID: 8022171735
Enrollment ID: O20090107000136
Entity NameMichigan Healthcare Professionals Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1295023547
PECOS PAC ID: 0345413258
Enrollment ID: O20111109000027
Entity NameSeton Health Corporation Of Southeastern Michigan
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598177065
PECOS PAC ID: 2567689540
Enrollment ID: O20140814002590

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole M Pettibone is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Nicole M Pettibone, LMSW
2800 Livernois Rd,
Troy, MI 48083-1215

Ph: () -		Nicole M Pettibone, LMSW
22255 Greenfield Rd Ste 550,
Southfield, MI 48075-3730

Ph: (844) 576-9226

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.