Latiere Wallace, APRN in Dade City, FL - Medicare Nurse Practitioner

Latiere Wallace, APRN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Dade City, Florida. Her current practice location is 14527 7th St, Dade City, Florida. You can reach out to her office (for appointments etc.) via phone at (352) 521-1474.

Latiere Wallace is licensed to practice in Florida (license number 11023599) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1518673854.

Contact Information

	Latiere Wallace, APRN
	14527 7th St, Dade City, FL 33523-3102
	(352) 521-1474
	Not Available

Map and Direction

Provider's Profile

Full Name	Latiere Wallace
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	14527 7th St, Dade City, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1518673854
Provider Enumeration Date: 01/30/2023
Last Update Date: 05/11/2023

Medicare PECOS Information:

PECOS PAC ID: 1254706732
Enrollment ID: I20230414001560

Medical Identifiers

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

Identifier	Type	State	Issuer
1518673854	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	11023599 (Florida)	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. Latiere Wallace allows following entities to bill medicare on her behalf.

Entity Name	Baycare Behavioral Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1225312549 PECOS PAC ID: 4688649122 Enrollment ID: O20040830000131

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. Latiere 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
Latiere Wallace, APRN 5222 Blue Roan Way, Wesley Chapel, FL 33544-1829 Ph: (727) 510-5070	Latiere Wallace, APRN 14527 7th St, Dade City, FL 33523-3102 Ph: (352) 521-1474

Reviews and Comments

Nurse Practitioner Nurses in Dade City, FL

Dorothy R Budetti, A.R.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13941 15th St, Dade City, FL 33525 Phone: 352-521-1450 Fax: 352-523-6910
Kirsten T Rhoden, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13417 Us Highway 301 Ste B, Dade City, FL 33525 Phone: 352-521-3967
Jessica Lynn Faber, PMNHP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 14527 7th St, Dade City, FL 33523 Phone: 352-521-1474
Mrs. Terri Lynn Jones, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12880 Us Highway 301, Dade City, FL 33525 Phone: 352-567-3325 Fax: 352-567-3385
Barbara Rose Muniz, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 13417 Us Highway 301 Ste D, Dade City, FL 33525 Phone: 352-567-8640 Fax: 813-355-5027
Shauna M Deschamps, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13540 17th St, Dade City, FL 33525 Phone: 352-437-3107 Fax: 352-437-3120
Margaret E Young, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13417 Us Highway 301, Dade City, FL 33525 Phone: 352-521-3967 Fax: 352-521-4967

Latiere Wallace, APRN - Medicare Nurse Practitioner in Dade City, FL