Mr Kenneth T Wallenfelsz, ARNP is a medicare enrolled "Nurse Practitioner - Family" in Reedsport, Oregon. His current practice location is
620 Ranch Rd, Reedsport, Oregon. You can reach out to his office (for appointments etc.) via phone at
(541) 271-2163.
Mr Kenneth T Wallenfelsz is licensed to practice in Oregon (license number 201500491NP-PP) 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 1457649998.
Provider's Profile
Full Name | Mr Kenneth T Wallenfelsz |
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Gender | Male |
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Speciality | Nurse Practitioner - Family |
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Location | 620 Ranch Rd, Reedsport, Oregon |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1457649998
- Provider Enumeration Date: 07/19/2011
- Last Update Date: 05/08/2024
Medicare PECOS Information:
- PECOS PAC ID: 0749433506
- Enrollment ID: I20130104000244
Medical Identifiers
Medical identifiers for Mr Kenneth T Wallenfelsz such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1457649998 | NPI | - | NPPES |
276263 | Medicaid | OR | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | AP60207225 (Washington) | Secondary |
363LF0000X | Nurse Practitioner - Family | AP60207225 (Washington) | Secondary |
363LF0000X | Nurse Practitioner - Family | 201500491NP-PP (Oregon) | 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. Mr Kenneth T Wallenfelsz allows following entities to bill medicare on his behalf.
Entity Name | Jefferson County Public Hospital District No 2 |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1356492953 PECOS PAC ID: 4789593708 Enrollment ID: O20031111000542 |
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Entity Name | Sound Physicians Emergency Medicine Of Washington Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1629532064 PECOS PAC ID: 7315279007 Enrollment ID: O20191030000855 |
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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 Kenneth T Wallenfelsz 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 Kenneth T Wallenfelsz, ARNP 620 Ranch Rd, Reedsport, OR 97467-1720 Ph: (541) 271-2163 | Mr Kenneth T Wallenfelsz, ARNP 620 Ranch Rd, Reedsport, OR 97467-1720 Ph: (541) 271-2163 |
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