Mrs Mary Melanie Waller, MD is a medicare enrolled "Urology" physician in Olney, Illinois. She went to Uniformed Services Uhs Fe Hebert School Of Med and graduated in 1982 and has 42 years of diverse experience with area of expertise as Urology. She is a member of the group practice Richland Memorial Hospital Inc and her current practice location is
1200 N East St, Olney, Illinois. You can reach out to her office (for appointments etc.) via phone at
(618) 395-5222.
Mrs Mary Melanie Waller is licensed to practice in Illinois (license number 036119328) 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 1225024615.
Physician's Profile
Full Name | Mrs Mary Melanie Waller |
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Gender | Female |
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Speciality | Urology |
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Experience | 42 Years |
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Location | 1200 N East St, Olney, Illinois |
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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:
- Mrs Mary Melanie Waller attended and graduated from Uniformed Services Uhs Fe Hebert School Of Med in 1982
NPI Data:
- NPI Number: 1225024615
- Provider Enumeration Date: 09/21/2005
- Last Update Date: 10/05/2009
Medicare PECOS Information:
- PECOS PAC ID: 4789665928
- Enrollment ID: I20080315000039
Medical Identifiers
Medical identifiers for Mrs Mary Melanie Waller such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1225024615 | NPI | - | NPPES |
036119328 | Medicaid | IL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208800000X | Urology | 036119328 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Richland Memorial Hospital Inc | 3870565732 | 91 |
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. Mrs Mary Melanie Waller allows following entities to bill medicare on her behalf.
Entity Name | Richland Memorial Hospital Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1467492124 PECOS PAC ID: 3870565732 Enrollment ID: O20040811000131 |
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Entity Name | Carle Health Care Incorporated |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1154653947 PECOS PAC ID: 3577515774 Enrollment ID: O20100513000829 |
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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. Mrs Mary Melanie Waller 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 |
Mrs Mary Melanie Waller, MD Po Box 97, Olney, IL 62450-0097 Ph: (618) 395-7340 | Mrs Mary Melanie Waller, MD 1200 N East St, Olney, IL 62450-2432 Ph: (618) 395-5222 |
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