Jemila Ali, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" physician in Grand Rapids, Michigan. Her current practice location is
3950 Sparks Dr Se, Grand Rapids, Michigan. You can reach out to her office (for appointments etc.) via phone at
(616) 726-1318.
Jemila Ali is licensed to practice in Michigan (license number 4704274701) 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 1417626771.
Physician's Profile
Full Name | Jemila Ali |
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Gender | Female |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 3950 Sparks Dr Se, Grand Rapids, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1417626771
- Provider Enumeration Date: 09/09/2021
- Last Update Date: 09/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 1254719958
- Enrollment ID: I20220609000215
Medical Identifiers
Medical identifiers for Jemila Ali such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1417626771 | NPI | - | NPPES |
0D12824 | Other | MI | BCBS |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2084P0800X | Psychiatry & Neurology - Psychiatry | 470474701 (Michigan) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 4704274701 (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. Jemila Ali allows following entities to bill medicare on her behalf.
Entity Name | Downriver Mental Health Clinic Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1295866135 PECOS PAC ID: 7911995139 Enrollment ID: O20040505000533 |
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Entity Name | Family Health Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1811065576 PECOS PAC ID: 1759370216 Enrollment ID: O20040510000899 |
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Entity Name | Recovery Physicians Network Of Michigan |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1689343683 PECOS PAC ID: 5597162552 Enrollment ID: O20210920000260 |
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Entity Name | Supportive Care I Of Michigan Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1548995608 PECOS PAC ID: 9638554298 Enrollment ID: O20220916003011 |
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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. Jemila Ali 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 Address | Practice Location Address |
Jemila Ali, 3475 Belle Chase Way, Lansing, MI 48911-4252 Ph: (517) 882-3732 | Jemila Ali, 3950 Sparks Dr Se, Grand Rapids, MI 49546-6159 Ph: (616) 726-1318 |
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