Mr Shawn Michael Wallace, PA-C in Rio Rancho, NM

Mr Shawn Michael Wallace, PA-C is a medicare enrolled "Physician Assistant" in Rio Rancho, New Mexico. His current practice location is 2400 Unser Blvd Se Ste 08100, Rio Rancho, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 253-6100.

Mr Shawn Michael Wallace is licensed to practice in New Mexico (license number PA2022-0064) 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 1124614706.

Contact Information

	Mr Shawn Michael Wallace, PA-C
	2400 Unser Blvd Se Ste 08100, Rio Rancho, NM 87124
	(505) 253-6100
	(505) 253-6186

Map and Direction

Provider's Profile

Full Name	Mr Shawn Michael Wallace
Gender	Male
Speciality	Physician Assistant
Location	2400 Unser Blvd Se Ste 08100, Rio Rancho, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1124614706
Provider Enumeration Date: 12/17/2020
Last Update Date: 10/28/2022

Medicare PECOS Information:

PECOS PAC ID: 1153704390
Enrollment ID: I20220819002393

Medical Identifiers

Medical identifiers for Mr Shawn Michael Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124614706	NPI	-	NPPES
11783338	Medicaid	NM

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	PA2022-0064 (New Mexico)	Primary

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 Shawn Michael 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 Shawn Michael Wallace, PA-C Po Box 26666, Phs Provider Enrollment, Albuquerque, NM 87125-6666 Ph: (505) 923-6770	Mr Shawn Michael Wallace, PA-C 2400 Unser Blvd Se Ste 08100, Rio Rancho, NM 87124 Ph: (505) 253-6100

Reviews and Comments

Physician Assistant Nurses in Rio Rancho, NM

Kimberley B. Oldewage, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1350 Jackie Road Ste 101, Westside Family Medicine, Rio Rancho, NM 87124 Phone: 505-892-7518 Fax: 505-892-9092
Rebecca Lynn Bourbon, P.A.-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4005 High Resort Blvd Se, Rio Rancho, NM 87124 Phone: 505-462-6000 Fax: 505-462-8472
Daniel Ray Spohn, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1630 Rio Rancho Dr Se, Rio Rancho, NM 87124 Phone: 505-395-5520
Alisha Plummer, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144 Phone: 505-994-7607 Fax: 505-994-7255
Sydney Rose George, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2400 Unser Blvd Se, Ste 18200, Rio Rancho, NM 87124 Phone: 505-563-6565
Martin Lee Taylor, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 914 Pinehurst Road Se, Suite 102, Rio Rancho, NM 87124 Phone: 505-896-9412 Fax: 505-896-2505
Lauren E. Atkinson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2400 Unser Blvd Se, Rio Rancho, NM 87124 Phone: 505-253-6100

Mr Shawn Michael Wallace, PA-C - Medicare Physician Assistant in Rio Rancho, NM