Mrs Keisha Diane Malone, PMHNP-BC in Redford, MI

Mrs Keisha Diane Malone, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Redford, Michigan. Her current practice location is 15611 Fox, Redford, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 207-5843.

Mrs Keisha Diane Malone is licensed to practice in Michigan (license number 4704301992) 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 1366177156.

Contact Information

	Mrs Keisha Diane Malone, PMHNP-BC
	15611 Fox, Redford, MI 48239-3976
	(313) 207-5843
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Keisha Diane Malone
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	15611 Fox, 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: 1366177156
Provider Enumeration Date: 07/18/2022
Last Update Date: 07/18/2022

Medicare PECOS Information:

PECOS PAC ID: 5193108504
Enrollment ID: I20220818000197

Medical Identifiers

Medical identifiers for Mrs Keisha Diane Malone such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366177156	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	4704301992 (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. Mrs Keisha Diane Malone allows following entities to bill medicare on her behalf.

Entity Name	Molina Care Connections Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407243223 PECOS PAC ID: 5799062881 Enrollment ID: O20180320001095

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. Mrs Keisha Diane Malone 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
Mrs Keisha Diane Malone, PMHNP-BC 15611 Fox, Redford, MI 48239-3976 Ph: (313) 207-5843	Mrs Keisha Diane Malone, PMHNP-BC 15611 Fox, Redford, MI 48239-3976 Ph: (313) 207-5843

Reviews and Comments

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Mrs Keisha Diane Malone, PMHNP-BC - Medicare Nurse Practitioner in Redford, MI