Marlene Mb Wallace, CRNA - Medicare Nurse Anesthetist, Certified Registered in Jber, AK

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Marlene Mb Wallace, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Jber, Alaska. Her current practice location is 5955 Zeamer Ave, 673rd Medical Group/sghq Dod-va Joint Venture Hospital, Jber, Alaska. You can reach out to her office (for appointments etc.) via phone at (907) 580-1035.

Marlene Mb Wallace is licensed to practice in Illinois (license number 209012095) 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 1629037676.

Contact Information

Marlene Mb Wallace, CRNA
5955 Zeamer Ave, 673rd Medical Group/sghq Dod-va Joint Venture Hospital,
Jber, AK 99506-3702
(907) 580-1035
(907) 580-3203

Map and Direction




Provider's Profile

Full NameMarlene Mb Wallace
GenderFemale
SpecialityNurse Anesthetist, Certified Registered
Location5955 Zeamer Ave, Jber, Alaska
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1629037676
  • Provider Enumeration Date: 03/20/2006
  • Last Update Date: 02/13/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 1052784329
  • Enrollment ID: I20230307002745

Medical Identifiers

Medical identifiers for Marlene Mb Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629037676NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WP0000XRegistered Nurse - Pain Management 041305554 (Illinois)Secondary
367500000XNurse Anesthetist, Certified Registered 209012095 (Illinois)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. Marlene Mb Wallace allows following entities to bill medicare on her behalf.
Entity NameNorth American Partners In Anesthesia Illinois Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1699032524
PECOS PAC ID: 1052576519
Enrollment ID: O20120706000534

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. Marlene Mb 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
Marlene Mb Wallace, CRNA
5955 Zeamer Ave, 673rd Medical Group/sghq Dod-va Joint Venture Hospital,
Jber, AK 99506-3702

Ph: (907) 580-1035		Marlene Mb Wallace, CRNA
5955 Zeamer Ave, 673rd Medical Group/sghq Dod-va Joint Venture Hospital,
Jber, AK 99506-3702

Ph: (907) 580-1035

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Jber, AK

Christopher Cowley, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 5955 Zeamer Ave, 673 Mdg, Jber, AK 99506
Phone: 907-580-1815    
Daniel Thomas Perez, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 5955 Zeamer Ave, Jber, AK 99506
Phone: 907-580-1825    
Mr. David L Johnson, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 673 Mdg, 5955 Zeamer Avenue, Jber, AK 99506
Phone: 907-580-1815    
Carolyn N Lee, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 673 Mdg, 5955 Zeamer Avenue, Jber, AK 99506
Phone: 907-580-1815    
Jordan Fried,
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 5955 Zeamer Ave, Jber, AK 99506
Phone: 907-580-1820    
Dr. Thomas Guy Fevurly, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 5955 Zeamer Ave, 673d Mdg / Sgcs / Sgcj, Jber, AK 99506
Phone: 907-580-1815    Fax: 907-580-5524
Teresa R Sellers,
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 5955 Zeamer Ave, 673 Mdg, Jber, AK 99506
Phone: 907-580-1815    

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.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.