Dr Maxwell Wallace, MD in Saint Louis, MO - Medicare Psychiatry & Neurology

Dr Maxwell Wallace, MD is a medicare enrolled "Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology" physician in Saint Louis, Missouri. His current practice location is 1465 S Grand Blvd, Rm 2717, Saint Louis, Missouri. You can reach out to his office (for appointments etc.) via phone at (314) 577-5634.

Dr Maxwell Wallace is licensed to practice in Missouri (license number 2022027207) 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 1588195267.

Contact Information

	Dr Maxwell Wallace, MD
	1465 S Grand Blvd, Rm 2717, Saint Louis, MO 63104-1003
	(314) 577-5634
	(314) 577-5616

Map and Direction

Physician's Profile

Full Name	Dr Maxwell Wallace
Gender	Male
Speciality	Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology
Location	1465 S Grand Blvd, Saint Louis, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1588195267
Provider Enumeration Date: 03/23/2017
Last Update Date: 08/22/2022

Medicare PECOS Information:

PECOS PAC ID: 5890063788
Enrollment ID: I20220728002583

Medical Identifiers

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

Identifier	Type	State	Issuer
1588195267	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2084N0402X	Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology	2022027207 (Missouri)	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 Maxwell Wallace allows following entities to bill medicare on his behalf.

Entity Name	Ssm Cardinal Glennon Children's Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174577670 PECOS PAC ID: 7012828163 Enrollment ID: O20031231000604

Entity Name	Ssm Health Care Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306589544 PECOS PAC ID: 0143608372 Enrollment ID: O20220531002655

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 Maxwell 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 Maxwell Wallace, MD 1465 S Grand Blvd, Rm 2717, Saint Louis, MO 63104-1003 Ph: (314) 577-5634	Dr Maxwell Wallace, MD 1465 S Grand Blvd, Rm 2717, Saint Louis, MO 63104-1003 Ph: (314) 577-5634

Reviews and Comments

Psychiatry & Neurology Doctors in Saint Louis, MO

Dr. Lauren Flynn, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 231 W Lockwood Ave, Suite 202, Saint Louis, MO 63119 Phone: 314-737-4070
Dr. Antonina S Gesmundo, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1 Jefferson Barracks Dr, Saint Louis, MO 63125 Phone: 314-894-6636
Mr. Robert Harry Brady, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1430 Olive St, Suite 500, Saint Louis, MO 63103 Phone: 314-206-3724 Fax: 314-206-3708
Dr. Marcus E Raichle, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 517 S Euclid Ave, Ground Floor, Saint Louis, MO 63110 Phone: 314-362-6907 Fax: 314-747-3258
Rohit Pawar, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 10018 Kennerly Rd, Saint Louis, MO 63128 Phone: 314-525-7275 Fax: 314-525-7260
Dr. Rushaniya Albeptovna Khairova, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 24 S Kingshighway Blvd, Saint Louis, MO 63108 Phone: 314-286-1700 Fax: 314-286-1730
Dr. Alyssa E Smith, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1 Childrens Pl, Div Neurology Pediatrics, Saint Louis, MO 63110 Phone: 314-362-1408 Fax: 314-454-2523

Dr Maxwell Wallace, MD - Medicare Psychiatry & Neurology in Saint Louis, MO