Craig R Wallingford, DO is a medicare enrolled "Family Medicine" physician in Waterboro, Maine. His current practice location is
813 Main St, Massabesic Regional Medical Center, Waterboro, Maine. You can reach out to his office (for appointments etc.) via phone at
(207) 247-6131.
Craig R Wallingford is licensed to practice in Maine (license number 999) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1417935529.
Physician's Profile
| Full Name | Craig R Wallingford |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 813 Main St, Waterboro, Maine |
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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: 1417935529
- Provider Enumeration Date: 01/09/2006
- Last Update Date: 10/20/2024
Medicare PECOS Information:
- PECOS PAC ID: 6800815226
- Enrollment ID: I20060327000449
Medical Identifiers
Medical identifiers for Craig R Wallingford such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417935529 | NPI | - | NPPES |
| 120690000 | Medicaid | ME | |
| 000973 | Other | ME | ANTHEM BCBS |
| 010448809 | Other | ME | FEDERAL ID FOR DBA AS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 999 (Maine) | 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. Craig R Wallingford allows following entities to bill medicare on his behalf.
| Entity Name | Southern Maine Health Care |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659392819
PECOS PAC ID: 0143208348
Enrollment ID: O20040713001060 |
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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. Craig R Wallingford 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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Craig R Wallingford, DO
180 Center Rd,
Lebanon, ME 04027-3645
Ph: (207) 457-1461 | Craig R Wallingford, DO
813 Main St, Massabesic Regional Medical Center,
Waterboro, ME 04087-3006
Ph: (207) 247-6131 |
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