Holly A Wallace, APNP in Summit, WI - Medicare Nurse Practitioner

Holly A Wallace, APNP is a medicare enrolled "Nurse Practitioner" in Summit, Wisconsin. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Watertown Family Practice Associates, Sc and her current practice location is 36500 Aurora Dr, Summit, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (262) 434-1000.

Holly A Wallace is licensed to practice in Wisconsin (license number 9679) 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 1124660592.

Contact Information

	Holly A Wallace, APNP
	36500 Aurora Dr, Summit, WI 53066-4899
	(262) 434-1000
	(262) 434-5050

Map and Direction

Provider's Profile

Full Name	Holly A Wallace
Gender	Female
Speciality	Nurse Practitioner
Experience	5 Years
Location	36500 Aurora Dr, Summit, Wisconsin
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:

Holly A Wallace graduated from nursing school in 2019

NPI Data:

NPI Number: 1124660592
Provider Enumeration Date: 10/17/2019
Last Update Date: 07/27/2022

Medicare PECOS Information:

PECOS PAC ID: 7214369735
Enrollment ID: I20191121000030

Medical Identifiers

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

Identifier	Type	State	Issuer
1124660592	NPI	-	NPPES
100094369	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	9679 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Watertown Memorial Hospital	Watertown, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Watertown Family Practice Associates, Sc	4183608037	9

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. Holly A Wallace allows following entities to bill medicare on her behalf.

Entity Name	Watertown Family Practice Associates, Sc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811064942 PECOS PAC ID: 4183608037 Enrollment ID: O20040617000150

Entity Name	Oak Medical Sc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669910345 PECOS PAC ID: 0042595175 Enrollment ID: O20170331001848

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. Holly A 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 Address	Practice Location Address
Holly A Wallace, APNP 3301 W Forest Home Ave, Milwaukee, WI 53215-2843 Ph: (262) 434-1000	Holly A Wallace, APNP 36500 Aurora Dr, Summit, WI 53066-4899 Ph: (262) 434-1000

Reviews and Comments

Nurse Practitioner Nurses in Summit, WI

Mrs. Kelly S Campbell, ANP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 36500 Aurora Dr, Summit, WI 53066 Phone: 262-434-1000
Erika Breeser, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 36500 Aurora Dr, Summit, WI 53066 Phone: 262-434-1000
Jena Louise Cruciani, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 36500 Aurora Dr, Summit, WI 53066 Phone: 262-343-1000
Carrie A Petersen, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 36500 Aurora Dr, Summit, WI 53066 Phone: 262-434-1000
Andrea M Lovas, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 36500 Aurora Dr, Summit, WI 53066 Phone: 262-434-1000 Fax: 262-434-5050
Amy M Scott-egerbrecht, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 36500 Aurora Dr, Summit, WI 53066 Phone: 262-434-5000 Fax: 262-434-5950

Holly A Wallace, APNP - Medicare Nurse Practitioner in Summit, WI