Mr Jerrol B Wallace, CRNA in Baltimore, MD - Medicare Certified Registered Nurse Anesthetist (crna)

Mr Jerrol B Wallace, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Baltimore, Maryland. He graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Surgical Anesthesia Associates Pllc and his current practice location is 4940 Eastern Ave, Baltimore, Maryland. You can reach out to his office (for appointments etc.) via phone at (410) 550-0100.

Mr Jerrol B Wallace is licensed to practice in Maryland (license number R246272) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1316084932.

Contact Information

	Mr Jerrol B Wallace, CRNA
	4940 Eastern Ave, Baltimore, MD 21224-2735
	(410) 550-0100
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Jerrol B Wallace
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	10 Years
Location	4940 Eastern Ave, Baltimore, Maryland
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Jerrol B Wallace graduated from nursing school in 2014

NPI Data:

NPI Number: 1316084932
Provider Enumeration Date: 01/31/2007
Last Update Date: 02/16/2021

Medicare PECOS Information:

PECOS PAC ID: 2365515079
Enrollment ID: I20080714000354

Medical Identifiers

Medical identifiers for Mr Jerrol B Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1316084932	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	0024167758 (Virginia)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	R246272 (Maryland)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Surgical Anesthesia Associates Pllc	5890739205	115

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. Mr Jerrol B Wallace allows following entities to bill medicare on his behalf.

Entity Name	Surgical Anesthesia Associates Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811930647 PECOS PAC ID: 5890739205 Enrollment ID: O20230130001161

Entity Name	Inova Cares - Community
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1861131906 PECOS PAC ID: 9537526330 Enrollment ID: O20230609002576

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. Mr Jerrol B 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
Mr Jerrol B Wallace, CRNA 6201 Greenleigh Ave, Middle River, MD 21220-2004 Ph: (410) 933-6423	Mr Jerrol B Wallace, CRNA 4940 Eastern Ave, Baltimore, MD 21224-2735 Ph: (410) 550-0100

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Baltimore, MD

Ms. Jennifer Renee Pease Moreno, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: Jhu 600 N Wolfe St, Dept Anesthesia Critical Care Medicine- Blalock 14th Fl, Baltimore, MD 21287 Phone: 410-955-4552
Kristen Marll, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2401 W Belvedere Ave, Baltimore, MD 21215 Phone: 410-601-5209
Mrs. Victoria Volta Manger, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 900 S Caton Ave, Baltimore, MD 21229 Phone: 667-234-3045
Duncan Mcelfresh, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2401 W Belvedere Ave, Anesthesia Department, Baltimore, MD 21215 Phone: 410-601-5209 Fax: 410-601-9744
Mr. Michael W Hoban, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 301 Saint Paul St, Baltimore, MD 21202 Phone: 410-332-9375
Mrs. Dama Reter Yekeson-koffa, RN, SRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 4940 Eastern Ave, Anesthesia Department Bayview Medical Center, Baltimore, MD 21224 Phone: 443-694-8960 Fax: 410-356-5821
Kelly Mccarthy, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 22 S Greene St, Baltimore, MD 21201 Phone: 410-328-8667

Mr Jerrol B Wallace, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Baltimore, MD