Mallory Kristen Groff, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Landenberg, Pennsylvania. Her current practice location is
108 Walnut Run Rd, Landenberg, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(302) 217-6020.
Mallory Kristen Groff is licensed to practice in North Dakota (license number R48854) 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 1255961959.
Provider's Profile
| Full Name | Mallory Kristen Groff |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 108 Walnut Run Rd, Landenberg, Pennsylvania |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1255961959
- Provider Enumeration Date: 01/22/2020
- Last Update Date: 10/20/2024
Medicare PECOS Information:
- PECOS PAC ID: 4688003551
- Enrollment ID: I20240110005040
Medical Identifiers
Medical identifiers for Mallory Kristen Groff such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1255961959 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 163W00000X | Registered Nurse | 9426584 (Florida) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 7531 (Minnesota) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 161921 (Alaska) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 828441 (Nevada) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | R48854 (North Dakota) | 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. Mallory Kristen Groff allows following entities to bill medicare on her behalf.
| Entity Name | Diamond State Counseling Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760854590 PECOS PAC ID: 1850700899 Enrollment ID: O20210504002084 |
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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. Mallory Kristen Groff 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 |
Mallory Kristen Groff, 4023 Kennett Pike Unit 234, Wilmington, DE 19807-2018 Ph: (302) 217-6020 | Mallory Kristen Groff, 108 Walnut Run Rd, Landenberg, PA 19350-9305 Ph: (302) 217-6020 |
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