Phillip Tyler Wallace, APRN in Jacksonville, FL

Phillip Tyler Wallace, APRN is a medicare enrolled "Nurse Practitioner" in Jacksonville, Florida. He graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Respiratory Critical Care And Sleep Medicine Associates Inc and his current practice location is 1325 San Marco Blvd Ste 300, Jacksonville, Florida. You can reach out to his office (for appointments etc.) via phone at (904) 253-6910.

Phillip Tyler Wallace is licensed to practice in Florida (license number APRN11003275) 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 1821647447.

Contact Information

	Phillip Tyler Wallace, APRN
	1325 San Marco Blvd Ste 300, Jacksonville, FL 32207-8567
	(904) 253-6910
	(904) 253-6964

Map and Direction

Provider's Profile

Full Name	Phillip Tyler Wallace
Gender	Male
Speciality	Nurse Practitioner
Experience	5 Years
Location	1325 San Marco Blvd Ste 300, Jacksonville, Florida
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:

Phillip Tyler Wallace graduated from nursing school in 2019

NPI Data:

NPI Number: 1821647447
Provider Enumeration Date: 09/06/2019
Last Update Date: 09/19/2022

Medicare PECOS Information:

PECOS PAC ID: 2961734421
Enrollment ID: I20191101001897

Medical Identifiers

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

Identifier	Type	State	Issuer
1821647447	NPI	-	NPPES
104378700	Medicaid	FL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	APRN11003275 (Florida)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Baptist Health Medical Center - Jacksonville	Jacksonville, FL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Respiratory Critical Care And Sleep Medicine Associates Inc	3971602970	33

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. Phillip Tyler Wallace allows following entities to bill medicare on his behalf.

Entity Name	Respiratory Critical Care And Sleep Medicine Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1386622629 PECOS PAC ID: 3971602970 Enrollment ID: O20070615000138

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. Phillip Tyler 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
Phillip Tyler Wallace, APRN 1325 San Marco Blvd Ste 300, Jacksonville, FL 32207-8567 Ph: (904) 253-6910	Phillip Tyler Wallace, APRN 1325 San Marco Blvd Ste 300, Jacksonville, FL 32207-8567 Ph: (904) 253-6910

Reviews and Comments

Nurse Practitioner Nurses in Jacksonville, FL

Mrs. Rhode L. Jean-aleger, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 10075 Gate Pkwy N Apt 102, Jacksonville, FL 32246 Phone: 904-997-9844 Fax: 904-997-9844
Jennifer Salenga Arguilla, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8773 Perimeter Park Ct, Jacksonville, FL 32216 Phone: 904-493-3390 Fax: 904-493-3395
Xenia T Blount, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Jessica Pelkowski, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Shannon Kathleen Burns, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Christy Mcewen, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 836 Prudential Dr Ste 1700b, Unit 1, Jacksonville, FL 32207 Phone: 904-398-0125 Fax: 904-389-1832
Danielle Harper Key, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4425 Merrimac Ave, Jacksonville, FL 32210 Phone: 904-346-0050 Fax: 904-346-0080

Phillip Tyler Wallace, APRN - Medicare Nurse Practitioner in Jacksonville, FL