Deanna Wallace, NP is a medicare enrolled "Nurse Practitioner - Family" physician in Decatur, Illinois. She graduated from medical school in 2016 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Prairie Cardiovascular Consultants Ltd and her current practice location is
1770 E Lake Shore Dr Ste 105, Decatur, Illinois. You can reach out to her office (for appointments etc.) via phone at
(217) 422-6100.
Deanna Wallace is licensed to practice in Illinois (license number 209014278) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1609222579.
Physician's Profile
| Full Name | Deanna Wallace |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner |
|---|
| Experience | 8 Years |
|---|
| Location | 1770 E Lake Shore Dr Ste 105, Decatur, Illinois |
|---|
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Deanna Wallace graduated from medical school in 2016
NPI Data:
- NPI Number: 1609222579
- Provider Enumeration Date: 05/10/2016
- Last Update Date: 12/27/2021
Medicare PECOS Information:
- PECOS PAC ID: 5799074605
- Enrollment ID: I20160517000849
Medical Identifiers
Medical identifiers for Deanna Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609222579 | NPI | - | NPPES |
| P01657319 | Other | IL | RAILROAD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 209.014278 (Illinois) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 209014278 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Prairie Cardiovascular Consultants Ltd | 3173435880 | 85 |
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. Deanna Wallace allows following entities to bill medicare on her behalf.
| Entity Name | Prairie Cardiovascular Consultants Ltd |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1982714218
PECOS PAC ID: 3173435880
Enrollment ID: O20031103000090 |
|---|
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. Deanna 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 |
|---|
Deanna Wallace, NP
1770 E Lake Shore Dr Ste 105,
Decatur, IL 62521-3800
Ph: (217) 422-6100 | Deanna Wallace, NP
1770 E Lake Shore Dr Ste 105,
Decatur, IL 62521-3800
Ph: (217) 422-6100 |
Reviews and Comments