Khalillah S Ali, NP in Grand Prairie, TX - Medicare Nurse Practitioner

Khalillah S Ali, NP is a medicare enrolled "Nurse Practitioner - Family" in Grand Prairie, Texas. Her current practice location is 455 Gotland Dr, Grand Prairie, Texas. You can reach out to her office (for appointments etc.) via phone at (469) 831-3149.

Khalillah S Ali is licensed to practice in Texas (license number 682811) 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 1972521417.

Contact Information

	Khalillah S Ali, NP
	455 Gotland Dr, Grand Prairie, TX 75052-2570
	(469) 831-3149
	Not Available

Map and Direction

Provider's Profile

Full Name	Khalillah S Ali
Gender	Female
Speciality	Nurse Practitioner - Family
Location	455 Gotland Dr, Grand Prairie, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1972521417
Provider Enumeration Date: 07/17/2006
Last Update Date: 09/27/2023

Medicare PECOS Information:

PECOS PAC ID: 1951350560
Enrollment ID: I20050120000455

Medical Identifiers

Medical identifiers for Khalillah S Ali such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1972521417	NPI	-	NPPES
170329003	Medicaid	TX

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
364SH1100X	Clinical Nurse Specialist - Holistic	AP113331 (Texas)	Secondary
363LF0000X	Nurse Practitioner - Family	682811 (Texas)	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. Khalillah S Ali allows following entities to bill medicare on her behalf.

Entity Name	Kayenta Alternative Rural Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174692529 PECOS PAC ID: 3678558129 Enrollment ID: O20040621000422

Entity Name	Odette Louise Campbell, Md, Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366750325 PECOS PAC ID: 9335301829 Enrollment ID: O20120430000114

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. Khalillah S 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
Khalillah S Ali, NP 455 Gotland Dr, Grand Prairie, TX 75052-2570 Ph: (469) 831-3149	Khalillah S Ali, NP 455 Gotland Dr, Grand Prairie, TX 75052-2570 Ph: (469) 831-3149

Reviews and Comments

Nurse Practitioner Nurses in Grand Prairie, TX

Amber Mullins, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4203 S Carrier Pkwy, Grand Prairie, TX 75052 Phone: 972-642-3190
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Joy Ogbimi, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2922 Pegasus Ct, Grand Prairie, TX 75052 Phone: 214-809-0542
Akhere Isenalumhe, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3012 Fairview Dr, Grand Prairie, TX 75052 Phone: 972-533-5136
Mrs. Susan Renee Carlson, MSN, ANP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2740 N Hwy 360, Suite 100, Grand Prairie, TX 75050 Phone: 972-606-8300 Fax: 972-606-4940
Michael Owusu Agyemang, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2520 W I 20, Grand Prairie, TX 75052 Phone: 972-264-5858 Fax: 972-264-8800
Modupe Olatunde, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1020 S. Carrier Pwky, Grand Prairie, TX 75051 Phone: 214-743-1200

Khalillah S Ali, NP - Medicare Nurse Practitioner in Grand Prairie, TX