Ms Kelly A Wallace, CRNA in Saint Louis, MO - Medicare Certified Registered Nurse Anesthetist (crna)

Ms Kelly A Wallace, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Saint Louis, Missouri. She graduated from nursing school in 1991 and has 33 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Gateway Gastroenterology Inc, Comprehensive Anesthesia Care Pc, Orthomed Staffing Llc and her current practice location is 615 S New Ballas Rd, Sjmmc Dept Of Anes, Saint Louis, Missouri. You can reach out to her office (for appointments etc.) via phone at (636) 386-9224.

Ms Kelly A Wallace is licensed to practice in Missouri (license number 121517) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1669464350.

Contact Information

	Ms Kelly A Wallace, CRNA
	615 S New Ballas Rd, Sjmmc Dept Of Anes, Saint Louis, MO 63141-8221
	(636) 386-9224
	(636) 386-7679

Map and Direction

Provider's Profile

Full Name	Ms Kelly A Wallace
Gender	Female
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	33 Years
Location	615 S New Ballas Rd, Saint Louis, Missouri
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Ms Kelly A Wallace graduated from nursing school in 1991

NPI Data:

NPI Number: 1669464350
Provider Enumeration Date: 08/18/2005
Last Update Date: 06/29/2010

Medicare PECOS Information:

PECOS PAC ID: 0941209142
Enrollment ID: I20061218000173

Medical Identifiers

Medical identifiers for Ms Kelly A Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1669464350	NPI	-	NPPES
916940117	Medicaid	MO

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	121517 (Missouri)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Gateway Gastroenterology Inc	2668448713	11
Comprehensive Anesthesia Care Pc	5799698551	39
Orthomed Staffing Llc	9638429178	252

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. Ms Kelly A Wallace allows following entities to bill medicare on her behalf.

Entity Name	Comprehensive Anesthesia Care Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1215975156 PECOS PAC ID: 5799698551 Enrollment ID: O20031107000275

Entity Name	Joseph A Bendet Anesthesia Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881755288 PECOS PAC ID: 2163316258 Enrollment ID: O20040211000157

Entity Name	Gateway Gastroenterology Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043250400 PECOS PAC ID: 2668448713 Enrollment ID: O20040909000422

Entity Name	Uap Scopes Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043636798 PECOS PAC ID: 1052535689 Enrollment ID: O20140620001426

Entity Name	Orthomed Staffing Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1225514276 PECOS PAC ID: 9638429178 Enrollment ID: O20220505000502

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. Ms Kelly A 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
Ms Kelly A Wallace, CRNA 339 Consort Dr, Ballwin, MO 63011-4439 Ph: (636) 386-9224	Ms Kelly A Wallace, CRNA 615 S New Ballas Rd, Sjmmc Dept Of Anes, Saint Louis, MO 63141-8221 Ph: (636) 386-9224

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Saint Louis, MO

Ms. Mary Katherine Kinworthy, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 12634 Olive Blvd, Dept Anesthesiology, Saint Louis, MO 63141 Phone: 800-862-9980 Fax: 314-362-1185
Ms. Kelsey Elise Fogus, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Barnes Jewish Hospital Plz, Dept Anesthesiology, Saint Louis, MO 63110 Phone: 800-862-9980 Fax: 314-362-1185
Ms. Claira J Sousa, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Barnes Jewish Hospital Plz, Dept Anesthesiology, Saint Louis, MO 63110 Phone: 800-862-9980 Fax: 314-362-1185
Claire Aubuchon, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 129 N Ballas Rd, Saint Louis, MO 63122 Phone: 314-996-5330 Fax: 314-810-1399
Mr. Aaron M Weinzettel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Barnes Jewish Hospital Plz, Dept Anesthesiology, Saint Louis, MO 63110 Phone: 800-862-9980 Fax: 314-362-1185
Ms. Tracy Lanes, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110 Phone: 314-362-6973 Fax: 314-362-1185
Mr. Michael Mccamley, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 12634 Olive Blvd, Saint Louis, MO 63141 Phone: 314-996-8685 Fax: 314-996-8479

Ms Kelly A Wallace, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Saint Louis, MO