Blake Wollam, in Mentor, OH - Medicare Nurse Practitioner

Blake Wollam, is a medicare enrolled "Nurse Practitioner - Family" in Mentor, Ohio. His current practice location is 7060 Wayside Dr, Mentor, Ohio. You can reach out to his office (for appointments etc.) via phone at (440) 357-2770.

Blake Wollam is licensed to practice in Ohio (license number APRN.CNP.0031396) 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 1013643048.

Contact Information

	Blake Wollam,
	7060 Wayside Dr, Mentor, OH 44060-6527
	(440) 357-2770
	Not Available

Map and Direction

Provider's Profile

Full Name	Blake Wollam
Gender	Male
Speciality	Nurse Practitioner - Family
Location	7060 Wayside Dr, Mentor, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1013643048
Provider Enumeration Date: 08/01/2022
Last Update Date: 08/01/2022

Medicare PECOS Information:

PECOS PAC ID: 6103202023
Enrollment ID: I20220929003688

Medical Identifiers

Medical identifiers for Blake Wollam such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013643048	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	APRN.CNP.0031396 (Ohio)	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. Blake Wollam allows following entities to bill medicare on his behalf.

Entity Name	The Cleveland Clinic Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679525919 PECOS PAC ID: 1850203555 Enrollment ID: O20031103000049

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. Blake Wollam 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
Blake Wollam, 2157 Lakeland Ave, Lakewood, OH 44107-5715 Ph: (740) 457-6815	Blake Wollam, 7060 Wayside Dr, Mentor, OH 44060-6527 Ph: (440) 357-2770

Reviews and Comments

Nurse Practitioner Nurses in Mentor, OH

Gina Lynn Berardinelli, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9485 Mentor Ave Ste 102, Mentor, OH 44060 Phone: 440-266-5500 Fax: 440-266-5505
Mrs. Christina Scott, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9485 Mentor Ave, Ste 210, Mentor, OH 44060 Phone: 440-255-5571 Fax: 440-205-5744
Robert Kollar, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7232 Justin Way, Mentor, OH 44060 Phone: 440-578-8200
Mrs. Brittany Louise Skinner, C.N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9485 Mentor Avenue, Suite 210, Mentor, OH 44060 Phone: 440-255-5571 Fax: 440-205-5744
Robin Jean Mills, PMHNP-BC, RN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7232 Justin Way, Mentor, OH 44060 Phone: 440-578-8200
Rylie Mcpartland, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8445 Munson Rd, Mentor, OH 44060 Phone: 440-255-1700

Blake Wollam, - Medicare Nurse Practitioner in Mentor, OH