Kojo Wallace, MD in Bay Shore, NY - Medicare General Surgery

Kojo Wallace, MD is a medicare enrolled "Surgery - Trauma Surgery" physician in Bay Shore, New York. He went to Icahn School Of Medicine At Mount Sinai and graduated in 2015 and has 9 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice North Shore - Lij Medical Pc and his current practice location is 301 E Main St, Bay Shore, New York. You can reach out to his office (for appointments etc.) via phone at (631) 968-3000.

Kojo Wallace is licensed to practice in New York (license number 312140) 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 1720475866.

Contact Information

	Kojo Wallace, MD
	301 E Main St, Bay Shore, NY 11706-8408
	(631) 968-3000
	Not Available

Map and Direction

Physician's Profile

Full Name	Kojo Wallace
Gender	Male
Speciality	General Surgery
Experience	9 Years
Location	301 E Main St, Bay Shore, New York
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kojo Wallace attended and graduated from Icahn School Of Medicine At Mount Sinai in 2015

NPI Data:

NPI Number: 1720475866
Provider Enumeration Date: 04/15/2015
Last Update Date: 06/14/2024

Medicare PECOS Information:

PECOS PAC ID: 9830435411
Enrollment ID: I20211110001776

Medical Identifiers

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

Identifier	Type	State	Issuer
1720475866	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2086S0127X	Surgery - Trauma Surgery	312140 (New York)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Ns/lij Hs Southside Hospital	Bay shore, NY	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
North Shore - Lij Medical Pc	3375701568	5120

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. Kojo Wallace allows following entities to bill medicare on his behalf.

Entity Name	North Shore - Lij Medical Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262

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. Kojo 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
Kojo Wallace, MD 909 Station Way, Huntington Station, NY 11746-1971 Ph: () -	Kojo Wallace, MD 301 E Main St, Bay Shore, NY 11706-8408 Ph: (631) 968-3000

Reviews and Comments

Surgery Doctors in Bay Shore, NY

Dr. Bradley David Cohen, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 15 Park Ave, Bay Shore, NY 11706 Phone: 631-581-4400 Fax: 631-277-3750
Dr. Gerardo Antonio Vitiello, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 301 E Main St, Bay Shore, NY 11706 Phone: 631-968-3000
Michael Anthony Amaturo, Surgery Medicare: Accepting Medicare Assignments Practice Location: 301 E Main St, Bay Shore, NY 11706 Phone: 631-894-5200
Dr. Manal Hegazy, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 15 Park Ave, Bay Shore, NY 11706 Phone: 631-581-4400 Fax: 631-277-3750
Alexandra Capece, DO Surgery Medicare: Medicare Enrolled Practice Location: 440 E Main St Ste A, Bay Shore, NY 11706 Phone: 520-414-8000
Dr. Charles A La Rosa, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 15 Park Ave, Bay Shore, NY 11706 Phone: 631-581-4400 Fax: 631-277-3750
Dr. Kelechi Akuma, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 250 E Main St, Bay Shore, NY 11706 Phone: 631-470-1460

Kojo Wallace, MD - Medicare General Surgery in Bay Shore, NY