Dr John Brent Wallis, MD in New Orleans, LA - Medicare Internal Medicine

Dr John Brent Wallis, MD is a medicare enrolled "Internal Medicine" physician in New Orleans, Louisiana. His current practice location is 4710 S Carrollton Ave, New Orleans, Louisiana. You can reach out to his office (for appointments etc.) via phone at (504) 454-9020.

Dr John Brent Wallis is licensed to practice in Louisiana (license number 025100) 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 1023004207.

Contact Information

	Dr John Brent Wallis, MD
	4710 S Carrollton Ave, New Orleans, LA 70119
	(504) 454-9020
	(504) 454-9031

Map and Direction

Physician's Profile

Full Name	Dr John Brent Wallis
Gender	Male
Speciality	Internal Medicine
Location	4710 S Carrollton Ave, New Orleans, Louisiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1023004207
Provider Enumeration Date: 09/23/2005
Last Update Date: 12/21/2012

Medicare PECOS Information:

PECOS PAC ID: 9638130412
Enrollment ID: I20041025000782

Medical Identifiers

Medical identifiers for Dr John Brent Wallis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1023004207	NPI	-	NPPES
1422355	Medicaid	LA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	025100 (Louisiana)	Primary
208000000X	Pediatrics	025100 (Louisiana)	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 John Brent Wallis allows following entities to bill medicare on his behalf.

Entity Name	Louisiana State University School Of Medicine In New Orleans Faculty G
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477582526 PECOS PAC ID: 0244136448 Enrollment ID: O20031209000661

Entity Name	Jencare Neighborhood Medical Center Midcity, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194085852 PECOS PAC ID: 1557508579 Enrollment ID: O20130513000065

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 John Brent Wallis 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 John Brent Wallis, MD 1000 Park Centre Blvd, Suite 100, Miami, FL 33169-5373 Ph: (504) 454-9020	Dr John Brent Wallis, MD 4710 S Carrollton Ave, New Orleans, LA 70119 Ph: (504) 454-9020

Reviews and Comments

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Dr John Brent Wallis, MD - Medicare Internal Medicine in New Orleans, LA