Charles M Walbaum, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Fredericktown, Missouri. His current practice location is
611 W Main St, Fredericktown, Missouri. You can reach out to his office (for appointments etc.) via phone at
(573) 783-3341.
Charles M Walbaum is licensed to practice in Missouri (license number 056545) 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 1023171741.
Provider's Profile
| Full Name | Charles M Walbaum |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 611 W Main St, Fredericktown, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1023171741
- Provider Enumeration Date: 12/18/2006
- Last Update Date: 02/27/2009
Medicare PECOS Information:
- PECOS PAC ID: 3577514561
- Enrollment ID: I20050208000102
Medical Identifiers
Medical identifiers for Charles M Walbaum such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1023171741 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 056545 (Missouri) | 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. Charles M Walbaum allows following entities to bill medicare on his behalf.
| Entity Name | Novamed Eye Surgery Center Of North County Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003260100
PECOS PAC ID: 6901866128
Enrollment ID: O20160720002627 |
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| Entity Name | Cpr Anesthesia Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1326436353
PECOS PAC ID: 7416272927
Enrollment ID: O20200625003307 |
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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. Charles M Walbaum 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 |
|---|
Charles M Walbaum, CRNA
611 W Main St,
Fredericktown, MO 63645-1111
Ph: (573) 783-3341 | Charles M Walbaum, CRNA
611 W Main St,
Fredericktown, MO 63645-1111
Ph: (573) 783-3341 |
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