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MALLORY DEVEREAUX PMHNP-BC
NPI 1316738842
Nurse Practitioner - Psychiatric/Mental Health in Grand Forks, ND

Active since May 14, 2025PECOS EnrolledAccepts Medicare Assignment
3674 S WASHINGTON ST, GRAND FORKS, ND 58201(701) 732-2538(701) 732-2501 Get Directions Write a Review

NPPES record last updated: January 22, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 22, 2026, May 14, 2025 (2 updates tracked since 2025).

About Mallory Devereaux Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALLORY DEVEREAUX PMHNP-BC (NPI 1316738842) is an individual psychiatric/mental health provider in Grand Forks, North Dakota, licensed in Florida (RN9450750) and active in the NPI registry since May 2025. The provider is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1316738842
Entity TypeIndividual
Primary Taxonomy363LP0808X
Provider Legal NameMALLORY DEVEREAUXCredential: PMHNP-BC
Location Address3674 S WASHINGTON STGrand Forks, ND 58201-5766
Mailing AddressPo Box 5210Grand Forks, ND 58206-5210 · (701) 205-3000 · Fax (701) 732-2501
Phone(701) 732-2538
Fax(701) 732-2501
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMay 14, 2025
Last NPPES UpdateJanuary 22, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 22, 2026
✔ NPI 1316738842 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in FL · RN9450750
3674 S WASHINGTON ST, Grand Forks, ND 58201
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, HealthPartners, Sanford Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mallory Devereaux Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729592548
PECOS Enrollment IDI20250703003387, I20250731001021, I20250820002527, I20251003003910, I20251003004045, I20251119000061, I20260407002353
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Mallory Devereaux reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Peterson Medical Clinics, LLC
Same address
Multi-Specialty
3674 S WASHINGTON ST
Grand Forks, ND 58201
  • Reassigned Medicare billing, Alaska, Florida, Minnesota, Montana, North Dakota and South Dakota enrollments
  • 70 clinicians in this Medicare group
NPI 1699295774 (701) 205-3000
Cowlitz Indian Tribe
1,217 mi
Rehabilitation, Substance Use Disorder
7105 NE 40TH ST
Vancouver, WA 98661
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Bristol Bay Area Health Corporation
  • 360 clinicians in this Medicare group
NPI 1538412630 (360) 353-9431
Yukon Kuskokwim Health Corporation
2,556 mi
Health Service
10 MORGAN ROAD, ANIAK SUBREGIONAL CLINIC
Aniak, AK 99557
  • Reassigned Medicare billing, Texas enrollment
  • 29 clinicians in this Medicare group
NPI 1689857658 (907) 543-6000
Norton Sound Health Corporation
2,709 mi
Critical Access
1000 GREG KRUSCHEK AVE
Nome, AK 99762
  • Reassigned Medicare billing, Alaska enrollment
  • Also billed through NPI 1225101041 (Alaska)
  • 193 clinicians in this Medicare group
NPI 1154358232 (907) 443-3311

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $55.75 – $168.12
Typical copayment $21.42 (range $13.93 – $42.03)
Most-billed visit code 99203
Established Patient
$98.29 typical visit price
range $18.11 – $137.65
Typical copayment $24.57 (range $4.52 – $34.41)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHERBIE DARBOUZE PA-C
Physician Assistant
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
MIRANDA EDEN DAVIS PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
MRS. REBECCA LYNNE OHLSON LCSW
Social Worker (Clinical)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
JALISA GILES LCSW
Social Worker (Clinical)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
GWEN LOTTA LCSW
Social Worker (Clinical)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
ASHLEY R STOWELL
Social Worker (Clinical)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
CHERYL TREDWAY LPCC, LCPC
Counselor (Professional)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
KELE FERREIRA PA-C
Physician Assistant
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mallory Devereaux's NPI number?

The NPI number for Mallory Devereaux is 1316738842. It was assigned to this individual provider in the NPPES registry on May 14, 2025.

Where is Mallory Devereaux located?

Mallory Devereaux practices at 3674 S Washington St, Grand Forks, ND 58201. The listed phone number is (701) 732-2538.

What is Mallory Devereaux's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Mallory Devereaux enrolled in Medicare?

Yes. Mallory Devereaux is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Mallory Devereaux's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mallory Devereaux reassigns Medicare benefits to 4 organizations: Peterson Medical Clinics, LLC (Grand Forks, ND), Cowlitz Indian Tribe (Vancouver, WA), Yukon Kuskokwim Health Corporation (Aniak, AK) and Norton Sound Health Corporation (Nome, AK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mallory Devereaux's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mallory Devereaux accept?

Health plans from Blue Cross Blue Shield of North Dakota, HealthPartners, Sanford Health Plan and Wellmark of South Dakota, Inc. list Mallory Devereaux as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mallory Devereaux was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.