Haily Wallace, MD - Medicare Family Practice in Tucumcari, NM

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Haily Wallace, MD is a medicare enrolled "Family Medicine" physician in Tucumcari, New Mexico. She went to University Of New Mexico School Of Medicine and graduated in 2012 and has 12 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Legacy Healthcare Services Inc, Sunrise Clinics, Presbyterian Healthcare Services and her current practice location is 402 E Miel De Luna Ave, Pmg At Dr Dan C Trigg Memorial Hospital, Tucumcari, New Mexico. You can reach out to her office (for appointments etc.) via phone at (575) 461-7100.

Haily Wallace is licensed to practice in New Mexico (license number MD2014-0895) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1679839534.

Contact Information

Haily Wallace, MD
402 E Miel De Luna Ave, Pmg At Dr Dan C Trigg Memorial Hospital,
Tucumcari, NM 88401-3828
(575) 461-7100
(575) 461-7101

Map and Direction




Physician's Profile

Full NameHaily Wallace
GenderFemale
SpecialityFamily Practice
Experience12 Years
Location402 E Miel De Luna Ave, Tucumcari, New Mexico
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Haily Wallace attended and graduated from University Of New Mexico School Of Medicine in 2012
  NPI Data:
  • NPI Number: 1679839534
  • Provider Enumeration Date: 04/05/2012
  • Last Update Date: 06/18/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 7719299338
  • Enrollment ID: I20150709002052

Medical Identifiers

Medical identifiers for Haily Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679839534NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine MD2014-0895 (New Mexico)Primary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Tucumcari Home HealthTucumcari, NMHome health agency
Dr Dan C Trigg Memorial HospitalTucumcari, NMHospital
Baptist St Anthony's HospitalAmarillo, TXHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Legacy Healthcare Services Inc21633397223341
Sunrise Clinics680022637421
Presbyterian Healthcare Services92340417081119

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. Haily Wallace allows following entities to bill medicare on her behalf.
Entity NamePresbyterian Healthcare Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104802354
PECOS PAC ID: 9234041708
Enrollment ID: O20031103000603
Entity NameSunrise Medical Group, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124107446
PECOS PAC ID: 6406744028
Enrollment ID: O20040305000978
Entity NameSunrise Clinics
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164055927
PECOS PAC ID: 6800226374
Enrollment ID: O20200423002808

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. Haily 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 AddressPractice Location Address
Haily Wallace, MD
Po Box 26666, Phs Provider Enrollment,
Albuquerque, NM 87125-6666

Ph: (505) 923-6770		Haily Wallace, MD
402 E Miel De Luna Ave, Pmg At Dr Dan C Trigg Memorial Hospital,
Tucumcari, NM 88401-3828

Ph: (575) 461-7100

Reviews and Comments


Family Medicine Doctors in Tucumcari, NM

Mudassir Mubeen Saleemi, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1302 E Main St, Tucumcari, NM 88401
Phone: 505-461-2200    Fax: 505-461-2213
Dr. Darrell E Willis, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 402 E Miel De Luna Ave, Tucumcari, NM 88401
Phone: 575-461-7100    Fax: 575-461-7101

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).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.