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

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



Provider's Profile

Full NameKhalillah S Ali
GenderFemale
SpecialityNurse Practitioner - Family
Location455 Gotland Dr, Grand Prairie, Texas
Accepts Medicare AssignmentsMedicare 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.
IdentifierTypeStateIssuer
1972521417NPI-NPPES
170329003MedicaidTX

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
364SH1100XClinical Nurse Specialist - Holistic AP113331 (Texas)Secondary
363LF0000XNurse 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 NameKayenta Alternative Rural Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174692529
PECOS PAC ID: 3678558129
Enrollment ID: O20040621000422

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Entity NameOdette Louise Campbell, Md, Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366750325
PECOS PAC ID: 9335301829
Enrollment ID: O20120430000114

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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. 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 AddressPractice 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

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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    
Mrs. Elsie Manuel, MSN, APRN, FNP-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2740 N Hwy 360, Grand Prairie, TX 75050
Phone: 972-606-8300    Fax: 972-606-8597
Joy Ogbimi,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
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
Quanica L Darden, APRN PNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2985 S State Highway 360, 140, Grand Prairie, TX 75052
Phone: 972-602-1166    

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