Wallace Bourgeois, MD in Boston, MA

Wallace Bourgeois, MD is a medicare enrolled "Pediatrics - Pediatric Hematology-oncology" physician in Boston, Massachusetts. His current practice location is 450 Brookline Ave, Boston, Massachusetts. You can reach out to his office (for appointments etc.) via phone at (617) 632-2423.

Wallace Bourgeois is licensed to practice in Massachusetts (license number 274015) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1811317209.

Contact Information

	Wallace Bourgeois, MD
	450 Brookline Ave, Boston, MA 02215-5418
	(617) 632-2423
	Not Available

Map and Direction

Physician's Profile

Full Name	Wallace Bourgeois
Gender	Male
Speciality	Pediatrics - Pediatric Hematology-oncology
Location	450 Brookline Ave, Boston, Massachusetts
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1811317209
Provider Enumeration Date: 04/24/2014
Last Update Date: 02/22/2021

Medicare PECOS Information:

PECOS PAC ID: 2365710886
Enrollment ID: I20210604000801

Medical Identifiers

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

Identifier	Type	State	Issuer
1811317209	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	274015 (Massachusetts)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary
2080P0207X	Pediatrics - Pediatric Hematology-oncology	274015 (Massachusetts)	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. Wallace Bourgeois allows following entities to bill medicare on his behalf.

Entity Name	Dana-farber Cancer Institute, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1851333686 PECOS PAC ID: 9133038904 Enrollment ID: O20040223000228

Entity Name	Children's Hospital Pediatric Associates, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457306664 PECOS PAC ID: 3476541830 Enrollment ID: O20040504000964

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. Wallace Bourgeois 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
Wallace Bourgeois, MD 44 Binney St # D-3119, Boston, MA 02115-6013 Ph: () -	Wallace Bourgeois, MD 450 Brookline Ave, Boston, MA 02215-5418 Ph: (617) 632-2423

Reviews and Comments

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Wallace Bourgeois, MD - Medicare Pediatrics in Boston, MA