Colleen Michelle Wallace, MD in Laurel, MD

Colleen Michelle Wallace, MD is a medicare enrolled "Pediatrics" physician in Laurel, Maryland. Her current practice location is 14113 Baltimore Ave Ste B, Laurel, Maryland. You can reach out to her office (for appointments etc.) via phone at (240) 360-5723.

Colleen Michelle Wallace is licensed to practice in Maryland (license number D78050) 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 1255627469.

Contact Information

	Colleen Michelle Wallace, MD
	14113 Baltimore Ave Ste B, Laurel, MD 20707-5073
	(240) 360-5723
	Not Available

Map and Direction

Physician's Profile

Full Name	Colleen Michelle Wallace
Gender	Female
Speciality	Pediatrics
Location	14113 Baltimore Ave Ste B, Laurel, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1255627469
Provider Enumeration Date: 06/26/2011
Last Update Date: 01/15/2025

Medicare PECOS Information:

PECOS PAC ID: 3971801895
Enrollment ID: I20160411000194

Medical Identifiers

Medical identifiers for Colleen Michelle Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1255627469	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208M00000X	Hospitalist	D78050 (Maryland)	Secondary
208000000X	Pediatrics	D78050 (Maryland)	Primary
208000000X	Pediatrics	0116023955 (Virginia)	Secondary

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. Colleen Michelle Wallace allows following entities to bill medicare on her behalf.

Entity Name	Baltimore Medical System, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1164138152 PECOS PAC ID: 5395653455 Enrollment ID: O20031121000651

Entity Name	University Of Maryland Community Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477530624 PECOS PAC ID: 3678472214 Enrollment ID: O20040102000687

Entity Name	Baltimore Washington Emergency Physicians, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1215983853 PECOS PAC ID: 3577451103 Enrollment ID: O20040305001004

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. Colleen 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
Colleen Michelle Wallace, MD 14113 Baltimore Ave Ste B, Laurel, MD 20707-5073 Ph: (240) 360-5723	Colleen Michelle Wallace, MD 14113 Baltimore Ave Ste B, Laurel, MD 20707-5073 Ph: (240) 360-5723

Reviews and Comments

Pediatrics Doctors in Laurel, MD

Dr. Nitin Mohan Chopde, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13976 Baltimore Ave, Laurel, MD 20707 Phone: 301-776-9000 Fax: 301-776-9259
Dr. Shahid Aziz, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 7300 Van Dusen Rd, Laurel, MD 20707 Phone: 301-725-4300
Dr. Lauren Ashley Baron, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 9811 Mallard Dr Ste 102, Laurel, MD 20708 Phone: 301-776-8000 Fax: 391-776-6753
Dr. Stephanie Wilks Perdue, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 9811 Mallard Dr, Suite 109, Laurel, MD 20708 Phone: 301-776-8000 Fax: 301-776-6753
Dr. Stanley Mcclellan Sinkford Iii, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 805 Washington Blvd S, Laurel, MD 20707 Phone: 301-686-5437 Fax: 301-686-5438
Angela E Duncan, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 7350 Van Dusen Rd Ste 110, Laurel, MD 20707 Phone: 301-498-8880 Fax: 301-498-7939
Dr. Mei-lin Lu, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 9811 Mallard Dr, Suite 109, Laurel, MD 20708 Phone: 301-776-8000 Fax: 301-776-8052

Colleen Michelle Wallace, MD - Medicare Pediatrics in Laurel, MD