Mrs Keisha Mack, FNP-C - Medicare Nurse Practitioner in New York, NY

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Mrs Keisha Mack, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in New York, New York. Her current practice location is 1 Penn Plz Fl 8, New York, New York. You can reach out to her office (for appointments etc.) via phone at (917) 991-9526.

Mrs Keisha Mack is licensed to practice in New York (license number 331233-1) 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 1487964631.

Contact Information

Mrs Keisha Mack, FNP-C
1 Penn Plz Fl 8,
New York, NY 10119-0899
(917) 991-9526
Not Available

Map and Direction




Provider's Profile

Full NameMrs Keisha Mack
GenderFemale
SpecialityNurse Practitioner - Family
Location1 Penn Plz Fl 8, New York, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1487964631
  • Provider Enumeration Date: 10/20/2010
  • Last Update Date: 07/17/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 4284852559
  • Enrollment ID: I20191030000523

Medical Identifiers

Medical identifiers for Mrs Keisha Mack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1487964631NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 26NJ00289600 (New Jersey)Secondary
363LF0000XNurse Practitioner - Family 331233-1 (New York)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 Mack allows following entities to bill medicare on her behalf.
Entity NameGenesis Medical Health Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1295043099
PECOS PAC ID: 9032308267
Enrollment ID: O20110104000820
Entity NameCare Connect Medical P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457032328
PECOS PAC ID: 0749641736
Enrollment ID: O20230808000676

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 Mack 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
Mrs Keisha Mack, FNP-C
1 Penn Plz Fl 8,
New York, NY 10119-0899

Ph: (917) 991-9526		Mrs Keisha Mack, FNP-C
1 Penn Plz Fl 8,
New York, NY 10119-0899

Ph: (917) 991-9526

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.

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