KELISHA MARK
NPI 1912667692
Social Worker in New York, NY
About Kelisha Mark NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELISHA MARK (NPI 1912667692) is an individual social worker in New York, New York, licensed in New York (100364) and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2008).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted 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
Kelisha Mark 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.
Medicare Billing Reassignment
Medicare enrollment records show Kelisha Mark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Staten Island, NY 10314
- Reassigned Medicare billing, New York enrollment
- 131 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Kelisha Mark's NPI number?
The NPI number for Kelisha Mark is 1912667692. It was assigned to this individual provider in the NPPES registry on December 22, 2021. The provider is also known as Kelisha Melbourne.
Where is Kelisha Mark located?
Kelisha Mark practices at 77 Water St, New York, NY 10005. The listed phone number is (347) 440-5869.
What is Kelisha Mark's specialty?
The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.
Is Kelisha Mark enrolled in Medicare?
Yes. Kelisha Mark 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 organization bills Medicare for Kelisha Mark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelisha Mark reassigns Medicare benefits to Integrity Social Work Services LLC (Staten Island, NY). The 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 Kelisha Mark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelisha Mark accept?
Health plans from Oscar Health, Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Kelisha Mark 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 Kelisha Mark was last updated on December 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Kelisha Mark · NPI 1912667692
Social Worker provider in New York, New York. Individual provider, active in the CMS NPPES registry since December 22, 2021.
## Identity
- **NPI:** 1912667692 (Entity type: Individual)
- **Enumerated:** December 22, 2021
- **Primary specialty:** Social Worker · taxonomy 104100000X
- **State license:** 100364 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 77 WATER ST, New York, NY 10005-4401
- **Phone:** (347) 440-5869
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Integrity Social Work Services LLC (NPI 1972715456, Staten Island, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2008
## Record status
- **NPPES last updated:** December 22, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1912667692) · Data from the CMS NPPES public registry.