David Wallace, MD in Belleville, IL - Medicare Internal Medicine

David Wallace, MD is a medicare enrolled "Internal Medicine - Cardiovascular Disease" physician in Belleville, Illinois. His current practice location is 340 W Lincoln St, Belleville, Illinois. You can reach out to his office (for appointments etc.) via phone at (618) 233-6044.

David Wallace is licensed to practice in Illinois (license number 036092919) 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 1609804525.

Contact Information

	David Wallace, MD
	340 W Lincoln St, Belleville, IL 62220-1900
	(618) 233-6044
	(618) 233-3287

Map and Direction

Physician's Profile

Full Name	David Wallace
Gender	Male
Speciality	Internal Medicine - Cardiovascular Disease
Location	340 W Lincoln St, Belleville, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1609804525
Provider Enumeration Date: 06/29/2006
Last Update Date: 04/17/2017

Medicare PECOS Information:

PECOS PAC ID: 1951380047
Enrollment ID: I20081010000495

Medical Identifiers

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

Identifier	Type	State	Issuer
1609804525	NPI	-	NPPES
0360929191	Medicaid	IL
107076	Other	MO	BCBS MO
2501200	Other		SECURE HORIZONS
37099690008	Other		GHP
E43629	Other		MERCY
12269	Other		ESSENCE
060046618	Other		RR MEDICARE
1734162	Other		UHC
205943608	Medicaid	MO
235649	Other		HEALTHLINK
235649	Other		WELLCARE
093355	Other		HEALTH ALLIANCE
54656	Other		CMR
P01024928	Other	IL	RAILROAD

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RC0000X	Internal Medicine - Cardiovascular Disease	036092919 (Illinois)	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. David Wallace allows following entities to bill medicare on his behalf.

Entity Name	Prairie Cardiovascular Consultants Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1659539559 PECOS PAC ID: 3173435880 Enrollment ID: O20031111000337

Entity Name	St. Elizabeth's Hospital Of The Hospital Sisters Of The Third Order Of
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194736728 PECOS PAC ID: 6406753011 Enrollment ID: O20031212000629

Entity Name	St Josephs Hospital Breese Of The Hospital Sisters Of The Third Order
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457319154 PECOS PAC ID: 9638064892 Enrollment ID: O20040217000493

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. David 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
David Wallace, MD 340 W Lincoln St, Belleville, IL 62220-1900 Ph: (618) 233-6044	David Wallace, MD 340 W Lincoln St, Belleville, IL 62220-1900 Ph: (618) 233-6044

Reviews and Comments

Internal Medicine Doctors in Belleville, IL

Dr. Dennis P Larson, M.D. Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 509 E Waters Edge Dr, Belleville, IL 62221 Phone: 618-235-1510 Fax: 618-235-1502
Kathleen K Fournier, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr, Suite 100, Belleville, IL 62226 Phone: 618-222-9999 Fax: 618-222-9337
Eldon Trame, M.D. Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 2900 Frank Scott Pkwy W, Suite 904, Belleville, IL 62223 Phone: 618-234-0640 Fax: 314-851-4475
Anand P. Patel, MD Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-257-6220
Eduardo Martinez-barrios, MD Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 4600 Memorial Dr, Suite 120, Belleville, IL 62226 Phone: 618-233-2220 Fax: 618-233-2555
Kashif Shahzad Bhutto, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 4600 Memorial Dr Ste 200, Belleville, IL 62226 Phone: 618-233-2220 Fax: 618-233-2555
Dr. David Nelson Pfohl, MD, FACP, GAQ Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 45 Pebble Hill Dr, Belleville, IL 62223 Phone: 618-604-6518

David Wallace, MD - Medicare Internal Medicine in Belleville, IL