Dr Wallace Lee Tracy, MD is a medicare enrolled "Family Medicine" physician in De Witt, Arkansas. He went to University Of Arkansas College Of Medicine and graduated in 1987 and has 38 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Dewitt Hospital And Nursing Home Inc, Mid-delta Health Systems Inc and his current practice location is
1940 S Whitehead Dr, De Witt, Arkansas. You can reach out to his office (for appointments etc.) via phone at
(870) 946-4505.
Dr Wallace Lee Tracy is licensed to practice in Arkansas (license number C7340) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1366438384.
Physician's Profile
| Full Name | Dr Wallace Lee Tracy |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 38 Years |
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| Location | 1940 S Whitehead Dr, De Witt, Arkansas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Wallace Lee Tracy attended and graduated from University Of Arkansas College Of Medicine in 1987
NPI Data:
- NPI Number: 1366438384
- Provider Enumeration Date: 09/26/2005
- Last Update Date: 09/16/2010
Medicare PECOS Information:
- PECOS PAC ID: 3274659495
- Enrollment ID: I20100924001157
Medical Identifiers
Medical identifiers for Dr Wallace Lee Tracy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366438384 | NPI | - | NPPES |
| 114942001 | Medicaid | AR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | C7340 (Arkansas) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Dewitt Hospital And Nursing Home Inc | 2961307616 | 6 |
| Mid-delta Health Systems Inc | 3870574668 | 11 |
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 Wallace Lee Tracy allows following entities to bill medicare on his behalf.
| Entity Name | Dewitt Hospital & Nursing Home Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972586238
PECOS PAC ID: 2961307616
Enrollment ID: O20040505001357 |
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| Entity Name | Mid-delta Health Systems Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1255346060
PECOS PAC ID: 3870574668
Enrollment ID: O20040527000492 |
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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 Wallace Lee Tracy 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 Wallace Lee Tracy, MD
1940 S Whitehead Dr, Po Box 471,
De Witt, AR 72042-2906
Ph: (870) 946-4505 | Dr Wallace Lee Tracy, MD
1940 S Whitehead Dr,
De Witt, AR 72042-2906
Ph: (870) 946-4505 |
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