Moira Petirs Wallace, MD in Jacksonville, FL - Medicare Emergency Medicine

Moira Petirs Wallace, MD is a medicare enrolled "Emergency Medicine" physician in Jacksonville, Florida. She went to Albert Einstein College Of Medicine Of Yeshiva University and graduated in 2008 and has 16 years of diverse experience with area of expertise as Emergency Medicine. She is a member of the group practice Cep America Llc, Paragon Emergency Services Llc and her current practice location is 3625 University Blvd S, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 702-6111.

Moira Petirs Wallace is licensed to practice in Florida (license number ME133941) 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 1053549212.

Contact Information

	Moira Petirs Wallace, MD
	3625 University Blvd S, Jacksonville, FL 32216-4207
	(904) 702-6111
	Not Available

Map and Direction

Physician's Profile

Full Name	Moira Petirs Wallace
Gender	Female
Speciality	Emergency Medicine
Experience	16 Years
Location	3625 University Blvd S, Jacksonville, Florida
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Moira Petirs Wallace attended and graduated from Albert Einstein College Of Medicine Of Yeshiva University in 2008

NPI Data:

NPI Number: 1053549212
Provider Enumeration Date: 06/26/2009
Last Update Date: 10/26/2023

Medicare PECOS Information:

PECOS PAC ID: 7517123383
Enrollment ID: I20180228000731

Medical Identifiers

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

Identifier	Type	State	Issuer
1053549212	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	A120516 (California)	Secondary
207P00000X	Emergency Medicine	ME133941 (Florida)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Sacred Heart Hospital	Pensacola, FL	Hospital
Ascension St Vincent's Southside	Jacksonville, FL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Cep America Llc	6608056171	569
Paragon Emergency Services Llc	8628153087	214

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. Moira Petirs Wallace allows following entities to bill medicare on her behalf.

Entity Name	Paragon Emergency Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1912101650 PECOS PAC ID: 8628153087 Enrollment ID: O20080310000143

Entity Name	Cep America Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295442614 PECOS PAC ID: 6608056171 Enrollment ID: O20230131002198

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. Moira Petirs 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
Moira Petirs Wallace, MD 830-13 A1a North, 232, Ponte Vedra, FL 32082 Ph: (714) 342-3689	Moira Petirs Wallace, MD 3625 University Blvd S, Jacksonville, FL 32216-4207 Ph: (904) 702-6111

Reviews and Comments

Emergency Medicine Doctors in Jacksonville, FL

Andrew Lim, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1504 Dunsford Rd, Jacksonville, FL 32207 Phone: 904-253-3734
Jennifer L. Mauzy, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 4201 Belfort Rd, Jacksonville, FL 32216 Phone: 904-296-3885
Max T Billingsley, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1 Shircliff Way, Emergency Department, Jacksonville, FL 32204 Phone: 904-346-5426 Fax: 904-346-0113
Kenneth Aung-din, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3625 University Blvd S, Jacksonville, FL 32216 Phone: 904-399-6811 Fax: 904-346-0113
Hannah Thomason Fox, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Dr. Daniel R Eraso, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 655 W 8th St, Jacksonville, FL 32209 Phone: 904-244-6340 Fax: 904-244-4508
Paul D Lucey, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Shircliff Way, Jacksonville, FL 32204 Phone: 904-308-7300 Fax: 904-346-0113

Moira Petirs Wallace, MD - Medicare Emergency Medicine in Jacksonville, FL