Laurie Wallace, DO - Medicare Emergency Medicine in Farmington Hills, MI

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Laurie Wallace, DO is a medicare enrolled "Emergency Medicine - Emergency Medical Services" physician in Farmington Hills, Michigan. Her current practice location is 28050 Grand River Ave, Er Department, Farmington Hills, Michigan. You can reach out to her office (for appointments etc.) via phone at (248) 471-8000.

Laurie Wallace is licensed to practice in Michigan (license number LW010385) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1699716613.

Contact Information

Laurie Wallace, DO
28050 Grand River Ave, Er Department,
Farmington Hills, MI 48336-5919
(248) 471-8000
Not Available

Map and Direction




Physician's Profile

Full NameLaurie Wallace
GenderFemale
SpecialityEmergency Medicine - Emergency Medical Services
Location28050 Grand River Ave, Farmington Hills, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1699716613
  • Provider Enumeration Date: 06/09/2006
  • Last Update Date: 11/28/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 9739076985
  • Enrollment ID: I20040309000166

Medical Identifiers

Medical identifiers for Laurie Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1699716613NPI-NPPES
114570889MedicaidMI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207PE0004XEmergency Medicine - Emergency Medical Services LW010385 (Michigan)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. Laurie Wallace allows following entities to bill medicare on her behalf.
Entity NameFarmington Emergency Medicine
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568496370
PECOS PAC ID: 6305732140
Enrollment ID: O20040302000665
Entity NameLegacy Physician Group Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801800719
PECOS PAC ID: 0648277830
Enrollment ID: O20061101000048

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. Laurie 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
Laurie Wallace, DO
Po Box 634087,
Cincinnati, OH 45263-0001

Ph: (800) 540-8739		Laurie Wallace, DO
28050 Grand River Ave, Er Department,
Farmington Hills, MI 48336-5919

Ph: (248) 471-8000

Reviews and Comments


Emergency Medicine Doctors in Farmington Hills, MI

Christine Carline, DO
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 28050 Grand River Ave, Farmington Hills, MI 48336
Phone: 947-521-8000    
Diane L Kaiser, DO
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 28050 Grand River Avenue, Farmington Hills, MI 48336
Phone: 248-471-8000    
Richard W Traicoff, DO
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 28050 Grand River Avenue, Er Department, Farmington Hills, MI 48336
Phone: 248-471-8000    
Iven Thair Ayyar, DO
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 28050 Grand River Ave, Farmington Hills, MI 48336
Phone: 947-521-8822    
Dr. Paul Marvin Pustinger, D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 28050 Grand River Ave, Farmington Hills, MI 48336
Phone: 248-471-8000    
Dr. Shradha Shah, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 28050 Grand River Ave, Botsford Hospital Emergency Department, Farmington Hills, MI 48336
Phone: 248-471-8808    
Dr. Kirsten Young, D.O.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 28050 Grand River Ave, Farmington Hills, MI 48336
Phone: 248-471-8000    

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.