Kimberly Mattina, - Medicare Nurse Practitioner in Southfield, MI

Kimberly Mattina, is a medicare enrolled "Nurse Practitioner - Acute Care" in Southfield, Michigan. Her current practice location is 26206 W 12 Mile Rd Ste 105, Southfield, Michigan. You can reach out to her office (for appointments etc.) via phone at (248) 200-3715.

Kimberly Mattina is licensed to practice in Michigan (license number 4704306684) 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 1104231083.

Contact Information

Kimberly Mattina,
26206 W 12 Mile Rd Ste 105,
Southfield, MI 48034-1799
(248) 200-3715
Not Available



Provider's Profile

Full NameKimberly Mattina
GenderFemale
SpecialityNurse Practitioner - Acute Care
Location26206 W 12 Mile Rd Ste 105, Southfield, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104231083
  • Provider Enumeration Date: 06/30/2014
  • Last Update Date: 09/07/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4082097662
  • Enrollment ID: I20220815001072

Medical Identifiers

Medical identifiers for Kimberly Mattina such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104231083NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care 4704306684 (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. Kimberly Mattina allows following entities to bill medicare on her behalf.
Entity NameHenry Ford Health System
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104900455
PECOS PAC ID: 0547178311
Enrollment ID: O20031210000341

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Entity NameHenry Ford Macomb Hospital Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1952440521
PECOS PAC ID: 7911808381
Enrollment ID: O20040617000651

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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. Kimberly Mattina 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
Kimberly Mattina,
1 Ford Pl Ste 3a,
Detroit, MI 48202-3450

Ph: () -
Kimberly Mattina,
26206 W 12 Mile Rd Ste 105,
Southfield, MI 48034-1799

Ph: (248) 200-3715

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Nurse Practitioner Nurses in Southfield, MI

Mrs. Theonna Monique Hindmon-harris, NURSE PRACTITIONER
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 21700 Northwestern Hwy Ste 815, Southfield, MI 48075
Phone: 248-557-3337    Fax: 248-557-3339
Charmaine Adegeye,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 25240 Lahser Rd Ste 2, Southfield, MI 48033
Phone: 248-564-1367    Fax: 734-725-6746
Ms. Jessica L Beacome, ACNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 16001 W 9 Mile Rd, 101 Fischer Center, Southfield, MI 48075
Phone: 248-849-8716    Fax: 248-849-2565
Teresea Ann Zarza, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 16001 W 9 Mile Rd, Southfield, MI 48075
Phone: 248-849-2528    Fax: 248-849-8256
Nicole Noel Silvestri, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 16001 W 9 Mile Rd, Southfield, MI 48075
Phone: 248-849-5806    Fax: 248-849-5489
Mrs. Caroline B Trapp, N.P.
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 29201 Telegraph Rd, Suite 404, Southfield, MI 48034
Phone: 248-355-0880    Fax: 248-355-9232
Mrs. Bernadette Ann Bruno, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 16001 W 9 Mile Rd, Southfield, MI 48075
Phone: 248-849-2536    

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