Stacey Bishop, NP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Redford, MI
NPI 1457059453 · NPPES record last updated Oct 9, 2024
Key facts
- NPI
- 1457059453
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 4704301475 (MI)
- Practice address
- 19393 Denby
Redford, MI 48240-1663 - Phone
- (702) 755-9244
- NPI assigned
- Feb 20, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Aldad Medical PC
Practice addresses (Care Compare)
1433 N Water St
Suite 400
Milwaukee, WI 53202-2603
Phone (516) 505-7200
200 S 1St St
Ann Arbor, MI 48104-1306
Phone (516) 505-7200
510 Hempstead Tpke
RM 203
West Hempstead, NY 11552-1152
Phone (516) 505-7200
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MI, NY, WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230609000498 | MI | Practitioner - Nurse Practitioner | 5395102156 | Reassigns benefits to 2 organizations |
| I20240419000318 | NY | Practitioner - Nurse Practitioner | 5395102156 | Reassigns benefits to 1 organization |
| I20250718002028 | WI | Practitioner - Nurse Practitioner | 5395102156 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 405735 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aldad Medical PC | Current |
Accepting new patients | |
| Aldad Medical PC | Current |
Accepting new patients | |
| Aldad Medical PC | Current |
Accepting new patients |
Locations
2723 S State St
Ste 150
Ann Arbor, MI 48104
Phone (734) 316-7880
200 S 1st St
Ann Arbor, MI 48104
Phone (718) 909-0464
400 Renaissance Ctr
Ste 2600
Detroit, MI 48243
Phone (248) 599-1582
27111 76th Ave
North New Hyde Pk, NY 11040
Phone (718) 289-2100
510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051
1433 N Water St
Ste 400
Milwaukee, WI 53202
Phone (414) 289-7154
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 405735 | NY | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 4704301475 | MI | Yes |
Addresses
Primary practice location
19393 Denby
Redford, MI 48240-1663
Mailing address
19393 Denby
Redford, MI 48240-1663
Phone (702) 755-9244
Other providers in Redford, MI
- Nicole Benson
- Best Care Home Healthcare LLC
- Best Daily Services Inc
- Best Urgent Care PC
- Shavon D. Bethel
- Carla Black
- Diane C Blaser
- Blossomcare, LLC
- Bluesky Care LLC
- Georgetta W Bond
All providers in Redford, MI · Psychiatric/Mental Health Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.