Dr Kenneth C Wallis, MD - Medicare Psychiatry & Neurology in Davis, CA

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Dr Kenneth C Wallis, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Davis, California. His current practice location is 1260 Lake Blvd, Suite #214, Davis, California. You can reach out to his office (for appointments etc.) via phone at (530) 771-2308.

Dr Kenneth C Wallis is licensed to practice in Utah (license number 811674181205) 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 1649243692.

Contact Information

Dr Kenneth C Wallis, MD
1260 Lake Blvd, Suite #214,
Davis, CA 95616-2614
(530) 771-2308
(530) 771-2309

Map and Direction




Physician's Profile

Full NameDr Kenneth C Wallis
GenderMale
SpecialityPsychiatry & Neurology - Psychiatry
Location1260 Lake Blvd, Davis, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1649243692
  • Provider Enumeration Date: 02/09/2006
  • Last Update Date: 07/09/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 3072769850
  • Enrollment ID: I20170828001513

Medical Identifiers

Medical identifiers for Dr Kenneth C Wallis such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1649243692NPI-NPPES
107005564101OtherUTINTRMTN. HEALTH CARE
261795OtherUTDESERET MUTUAL
942938348WA1OtherUTEDUCATORS MUTUAL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2084P0800XPsychiatry & Neurology - Psychiatry C-41960 (California)Secondary
2084P0800XPsychiatry & Neurology - Psychiatry 811674181205 (Utah)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. Dr Kenneth C Wallis allows following entities to bill medicare on his behalf.
Entity NameCounty Of Santa Clara
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659450955
PECOS PAC ID: 1254244973
Enrollment ID: O20040113000757
Entity NameCounty Of Santa Clara
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1699885079
PECOS PAC ID: 1254244973
Enrollment ID: O20040113000784
Entity NameCounty Of Solano
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508072588
PECOS PAC ID: 7911893177
Enrollment ID: O20040224001362
Entity NameCounty Of Santa Clara
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932313582
PECOS PAC ID: 1254244973
Enrollment ID: O20040413001159
Entity NameCounty Of Monterey
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467584805
PECOS PAC ID: 2466345632
Enrollment ID: O20040913001243
Entity NameCounty Of Santa Clara
Entity TypePart B Supplier - Other Medical Care Group
Entity IdentifiersNPI Number: 1629301346
PECOS PAC ID: 1254244973
Enrollment ID: O20110318000170

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 Kenneth C 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 AddressPractice Location Address
Dr Kenneth C Wallis, MD
1260 Lake Blvd, Suite #214,
Davis, CA 95616-2614

Ph: (530) 771-2308		Dr Kenneth C Wallis, MD
1260 Lake Blvd, Suite #214,
Davis, CA 95616-2614

Ph: (530) 771-2308

Reviews and Comments


Psychiatry & Neurology Doctors in Davis, CA

Emily Harris, M.D.
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Phone: 530-400-8963    
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Phone: 916-576-7898    Fax: 916-285-0338
Dr. Glenn E Fortini, M.D.
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Phone: 530-752-2300    Fax: 530-752-2306
Dr. Elizabeth Weatherford Bowler, MD
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Practice Location: 417 Mace Blvd, Suite J, Davis, CA 95618
Phone: 530-229-6585    
Dr. Helen Louise Krell, MD
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Practice Location: 433 F St, Davis, CA 95616
Phone: 530-756-7050    Fax: 530-758-9845
Dr. Tracy H Mccarthy, M.D.
Psychiatry & Neurology
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Practice Location: 1520 E. Covell Blvd Ste B5 #433, Davis, CA 95616
Phone: 916-581-2205    Fax: 916-414-8607

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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