Mr Spencer Waller, FNP in Pueblo, CO - Medicare Nurse Practitioner

Mr Spencer Waller, FNP is a medicare enrolled "Nurse Practitioner" in Pueblo, Colorado. His current practice location is 400 W 16th St, Pueblo, Colorado. You can reach out to his office (for appointments etc.) via phone at (719) 584-4306.

Mr Spencer Waller is licensed to practice in Colorado (license number ANP.0993430-NP) 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 1033629241.

Contact Information

	Mr Spencer Waller, FNP
	400 W 16th St, Pueblo, CO 81003-2781
	(719) 584-4306
	(719) 595-7886

Map and Direction

Provider's Profile

Full Name	Mr Spencer Waller
Gender	Male
Speciality	Nurse Practitioner
Location	400 W 16th St, Pueblo, Colorado
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033629241
Provider Enumeration Date: 10/03/2017
Last Update Date: 03/29/2018

Medicare PECOS Information:

PECOS PAC ID: 5799042701
Enrollment ID: I20171129003158

Medical Identifiers

Medical identifiers for Mr Spencer Waller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033629241	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	ANP.0993430-NP (Colorado)	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 Spencer Waller allows following entities to bill medicare on his behalf.

Entity Name	Parkview Medical Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730144684 PECOS PAC ID: 0143116673 Enrollment ID: O20040223001035

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 Spencer Waller 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 Spencer Waller, FNP 400 W 16th St, Pueblo, CO 81003-2781 Ph: (719) 584-4306	Mr Spencer Waller, FNP 400 W 16th St, Pueblo, CO 81003-2781 Ph: (719) 584-4306

Reviews and Comments

Nurse Practitioner Nurses in Pueblo, CO

Paula Jiron-finn, ACNP/FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 115 E Riverwalk Unit 200, Pueblo, CO 81003 Phone: 719-543-8346 Fax: 719-545-1829
Brian C White, APRN, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 226 1/2 S Union Ave Unit 205, Pueblo, CO 81003 Phone: 719-225-0637
Monica A Flynn, APRN-NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 41 Montebello Rd, Pueblo, CO 81001 Phone: 719-545-2746 Fax: 719-584-0110
Coral Breanne Martinez, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1600 N Grand Ave Ste 150, Pueblo, CO 81003 Phone: 719-595-7680
Alexandria Brook Davis-mitchell, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 41 Montebello Rd Ste 116, Pueblo, CO 81001 Phone: 719-423-1500
Lynne M Evetts, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 300 Colorado Ave, Pueblo, CO 81004 Phone: 719-543-8711 Fax: 719-543-5340
Phebe Golden, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3670 Parker Blvd Ste 101, Pueblo, CO 81008 Phone: 719-562-2900

Mr Spencer Waller, FNP - Medicare Nurse Practitioner in Pueblo, CO