Dr Danielle Charisse Wallace, MD in Winter Park, FL

Dr Danielle Charisse Wallace, MD is a medicare enrolled "Pediatrics" physician in Winter Park, Florida. Her current practice location is 1801 Lee Rd Ste 165, Winter Park, Florida. You can reach out to her office (for appointments etc.) via phone at (407) 975-0410.

Dr Danielle Charisse Wallace is licensed to practice in Florida (license number ME129213) 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 1114147006.

Contact Information

	Dr Danielle Charisse Wallace, MD
	1801 Lee Rd Ste 165, Winter Park, FL 32789
	(407) 975-0410
	(407) 975-0413

Map and Direction

Physician's Profile

Full Name	Dr Danielle Charisse Wallace
Gender	Female
Speciality	Pediatrics
Location	1801 Lee Rd Ste 165, Winter Park, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114147006
Provider Enumeration Date: 04/26/2007
Last Update Date: 06/13/2023

Medicare PECOS Information:

PECOS PAC ID: 7618020611
Enrollment ID: I20141008000863

Medical Identifiers

Medical identifiers for Dr Danielle Charisse Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114147006	NPI	-	NPPES
2231891	Medicaid	WA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	MD61340360 (Washington)	Secondary
208000000X	Pediatrics	ME129213 (Florida)	Primary
208000000X	Pediatrics	8023169-1205 (Utah)	Secondary
208000000X	Pediatrics	4301088447 (Michigan)	Secondary
208000000X	Pediatrics	U0741 (Texas)	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. Dr Danielle Charisse Wallace allows following entities to bill medicare on her behalf.

Entity Name	Huron Memorial Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245257880 PECOS PAC ID: 6800709221 Enrollment ID: O20040302000921

Entity Name	Mymichigan Medical Center Gladwin
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881869774 PECOS PAC ID: 0143262915 Enrollment ID: O20081024000094

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. Dr Danielle Charisse 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
Dr Danielle Charisse Wallace, MD 100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560 Ph: () -	Dr Danielle Charisse Wallace, MD 1801 Lee Rd Ste 165, Winter Park, FL 32789 Ph: (407) 975-0410

Reviews and Comments

Pediatrics Doctors in Winter Park, FL

Dr. Nicholo J. Sartor, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1801 Lee Rd Ste 165, Winter Park, FL 32789 Phone: 407-975-0410 Fax: 407-975-0413
Vanessa Alisa Gutierrez, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 200 N Lakemont Ave, Pediatric Inpt Care At Winter Park, Winter Park, FL 32792 Phone: 407-303-2528 Fax: 407-303-2760
Dr. Shivani Verma, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2660 W Fairbanks Ave, Winter Park, FL 32789 Phone: 407-898-2767 Fax: 407-898-9443
Clifford Allen Selsky, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2830 Casa Aloma Way, Winter Park, FL 32792 Phone: 407-335-4760 Fax: 877-695-8583
Md Saif Al Haque, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2325 W Fairbanks Ave, Winter Park, FL 32789 Phone: 407-539-0311
Dr. Frank Antolin Lopez, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1992 Mizell Ave, Winter Park, FL 32792 Phone: 407-644-4844 Fax: 407-644-6101

Dr Danielle Charisse Wallace, MD - Medicare Pediatrics in Winter Park, FL