Catherine Wallace, MD is a medicare enrolled "General Practice" physician in Dallas, Georgia. Her current practice location is
243 Merchants Dr, Dallas, Georgia. You can reach out to her office (for appointments etc.) via phone at
(770) 230-9967.
Catherine Wallace is licensed to practice in Georgia (license number 94669) 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 1154946606.
Physician's Profile
Full Name | Catherine Wallace |
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Gender | Female |
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Speciality | General Practice |
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Location | 243 Merchants Dr, Dallas, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1154946606
- Provider Enumeration Date: 06/10/2020
- Last Update Date: 05/02/2023
Medicare PECOS Information:
- PECOS PAC ID: 1557786282
- Enrollment ID: I20230228001205
Medical Identifiers
Medical identifiers for Catherine Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1154946606 | NPI | - | NPPES |
8101560001 | Other | GA | DME MAC JURISDICTION C |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 94669 (Georgia) | 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. Catherine Wallace allows following entities to bill medicare on her behalf.
Entity Name | Selano Chiropractic Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1609096213 PECOS PAC ID: 9032161864 Enrollment ID: O20050221000074 |
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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. Catherine 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 |
Catherine Wallace, MD 243 Merchants Dr Ste A, Dallas, GA 30132-4749 Ph: (404) 543-4506 | Catherine Wallace, MD 243 Merchants Dr, Dallas, GA 30132-4700 Ph: (770) 230-9967 |
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