Michelle Wallace, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Bend, Oregon. Her current practice location is
1340 Nw Wall St, Bend, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 322-7500.
Michelle Wallace is licensed to practice in Oregon (license number L11322) 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 1336796374.
Healthcare Provider's Profile
| Full Name | Michelle Wallace |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 1340 Nw Wall St, Bend, Oregon |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1336796374
- Provider Enumeration Date: 08/23/2019
- Last Update Date: 04/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 4385009323
- Enrollment ID: I20230427000519
Medical Identifiers
Medical identifiers for Michelle Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1336796374 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | L11322 (Oregon) | 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. Michelle Wallace allows following entities to bill medicare on her behalf.
| Entity Name | Deschutes County Oregon |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235172180
PECOS PAC ID: 9638083371
Enrollment ID: O20031117000568 |
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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. Michelle Wallace 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 |
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Michelle Wallace, LCSW
2577 Ne Courtney Dr,
Bend, OR 97701-7752
Ph: (541) 322-7500 | Michelle Wallace, LCSW
1340 Nw Wall St,
Bend, OR 97703-1985
Ph: (541) 322-7500 |
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