Dr Dane C Wallace, NURSE PRACTITIONER - Medicare Nurse Practitioner in Edwardsville, IL

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Dr Dane C Wallace, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Family" in Edwardsville, Illinois. His current practice location is 529 Hillsboro Ave, Edwardsville, Illinois. You can reach out to his office (for appointments etc.) via phone at (217) 621-8675.

Dr Dane C Wallace is licensed to practice in Illinois (license number 209.025563) 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 1528787744.

Contact Information

Dr Dane C Wallace, NURSE PRACTITIONER
529 Hillsboro Ave,
Edwardsville, IL 62025-1864
(217) 621-8675
Not Available

Map and Direction




Provider's Profile

Full NameDr Dane C Wallace
GenderMale
SpecialityNurse Practitioner - Family
Location529 Hillsboro Ave, Edwardsville, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1528787744
  • Provider Enumeration Date: 08/22/2022
  • Last Update Date: 11/06/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 7012393143
  • Enrollment ID: I20220927003038

Medical Identifiers

Medical identifiers for Dr Dane C Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1528787744NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 209.025563 (Illinois)Primary
363LF0000XNurse Practitioner - Family 2023036829 (Missouri)Secondary

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. Dr Dane C Wallace allows following entities to bill medicare on his behalf.
Entity NameCepamerica Illinois Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912283110
PECOS PAC ID: 3274793633
Enrollment ID: O20120322000587
Entity NameGranite City Emergency Medicine Providers Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861946626
PECOS PAC ID: 7012205784
Enrollment ID: O20161012001300
Entity NameVituity - Illinois Auc Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1306334198
PECOS PAC ID: 0547516932
Enrollment ID: O20180627000637
Entity NameAhs Il Medical Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659098101
PECOS PAC ID: 5496111676
Enrollment ID: O20230512001300

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. Dr Dane C 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 AddressPractice Location Address
Dr Dane C Wallace, NURSE PRACTITIONER
529 Hillsboro Ave,
Edwardsville, IL 62025-1864

Ph: (217) 621-8675		Dr Dane C Wallace, NURSE PRACTITIONER
529 Hillsboro Ave,
Edwardsville, IL 62025-1864

Ph: (217) 621-8675

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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