Candace Wilson, in Pine Bluff, AR - Medicare Family Medicine

Candace Wilson, is a medicare enrolled "Family Medicine" physician in Pine Bluff, Arkansas. Her current practice location is 1601 W 40th Ave Ste 100, Pine Bluff, Arkansas. You can reach out to her office (for appointments etc.) via phone at (870) 541-6000.

Candace Wilson is licensed to practice in Arkansas (license number E-17243) 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 1205456217.

Contact Information

	Candace Wilson,
	1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069
	(870) 541-6000
	(870) 541-6010

Map and Direction

Physician's Profile

Full Name	Candace Wilson
Gender	Female
Speciality	Family Medicine
Location	1601 W 40th Ave Ste 100, Pine Bluff, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1205456217
Provider Enumeration Date: 04/20/2020
Last Update Date: 10/18/2023

Medicare PECOS Information:

PECOS PAC ID: 9638529118
Enrollment ID: I20231224000125

Medical Identifiers

Medical identifiers for Candace Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1205456217	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	E-17243 (Arkansas)	Secondary
207Q00000X	Family Medicine	E-17243 (Arkansas)	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. Candace Wilson allows following entities to bill medicare on her behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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. Candace Wilson 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
Candace Wilson, 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 Ph: (870) 541-6000	Candace Wilson, 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 Ph: (870) 541-6000

Reviews and Comments

Family Medicine Doctors in Pine Bluff, AR

Mrs. Larisa Kachowski, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1726 W42d Ave, Pine Bluff, AR 71603 Phone: 870-619-4516
Simmie Armstrong Jr., M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1400 W 43rd Ave, Pine Bluff, AR 71603 Phone: 870-535-6461 Fax: 870-535-0594
Dr. Sree Chellappan, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603 Phone: 870-541-6000 Fax: 870-541-6010
Manuel R Kelley, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1101 Tennessee St, Pine Bluff, AR 71601 Phone: 870-543-2380 Fax: 870-535-4716
Pavana Naga Gopi Krishna Tirumanisetti, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 W 40th Ave, Pine Bluff, AR 71603 Phone: 870-541-6000 Fax: 870-541-6009
Dr. Toni L Middleton, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4010 S Mulberry St, Pine Bluff, AR 71603 Phone: 870-541-6000 Fax: 870-541-7622
Dr. Tracey Albertha Lockhart Wright, MD Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603 Phone: 870-540-6000 Fax: 870-541-6010

Candace Wilson, - Medicare Family Medicine in Pine Bluff, AR