Dr Kelly Susewitz Shakoor, FNP-BC in Redford, MI

Dr Kelly Susewitz Shakoor, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Redford, Michigan. Her current practice location is 9315 Telegraph Rd, Redford, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 450-4500.

Dr Kelly Susewitz Shakoor is licensed to practice in Michigan (license number 4704239124) 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 1043794829.

Contact Information

	Dr Kelly Susewitz Shakoor, FNP-BC
	9315 Telegraph Rd, Redford, MI 48239-1260
	(313) 450-4500
	Not Available

Map and Direction

Provider's Profile

Full Name	Dr Kelly Susewitz Shakoor
Gender	Female
Speciality	Nurse Practitioner - Family
Location	9315 Telegraph Rd, Redford, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043794829
Provider Enumeration Date: 09/18/2018
Last Update Date: 08/06/2019

Medicare PECOS Information:

PECOS PAC ID: 9234562430
Enrollment ID: I20191202001305

Medical Identifiers

Medical identifiers for Dr Kelly Susewitz Shakoor such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043794829	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	4704239124 (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. Dr Kelly Susewitz Shakoor allows following entities to bill medicare on her behalf.

Entity Name	Lincoln Behavioral Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669451944 PECOS PAC ID: 7113816612 Enrollment ID: O20040312000689

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. Dr Kelly Susewitz Shakoor 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
Dr Kelly Susewitz Shakoor, FNP-BC 4169 Kingston St, Dearborn Heights, MI 48125-3237 Ph: (734) 306-8586	Dr Kelly Susewitz Shakoor, FNP-BC 9315 Telegraph Rd, Redford, MI 48239-1260 Ph: (313) 450-4500

Reviews and Comments

Nurse Practitioner Nurses in Redford, MI

Brandie Keskes, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 14671 Telegraph Rd, Redford, MI 48239 Phone: 313-948-3055
Nathan Allen Johnson, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9315 Telegraph Rd, Redford, MI 48239 Phone: 313-450-4500 Fax: 313-450-4512
Alana Haas, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14671 Telegraph Rd, Redford, MI 48239 Phone: 313-948-3055
Roland H Gaines Jr., NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14140 Shamrock Dr, Redford, MI 48239 Phone: 313-858-1246
Jennifer Crosby, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14671 Telegraph Rd, Redford, MI 48239 Phone: 313-998-3030
Mrs. Theresa Player Rowry, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14329 Wormer, Redford, MI 48239 Phone: 313-580-1070

Dr Kelly Susewitz Shakoor, FNP-BC - Medicare Nurse Practitioner in Redford, MI