Naomi Susan Wallace, NP - Medicare Nurse Practitioner in Tyler, TX

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Naomi Susan Wallace, NP is a medicare enrolled "Nurse Practitioner" in Tyler, Texas. Her current practice location is 912 S Fleishel Ave, Tyler, Texas. You can reach out to her office (for appointments etc.) via phone at (903) 592-6901.

Naomi Susan Wallace is licensed to practice in Texas (license number 1128446) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1013699131.

Contact Information

Naomi Susan Wallace, NP
912 S Fleishel Ave,
Tyler, TX 75701-2018
(903) 592-6901
Not Available

Map and Direction




Provider's Profile

Full NameNaomi Susan Wallace
GenderFemale
SpecialityNurse Practitioner
Location912 S Fleishel Ave, Tyler, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1013699131
  • Provider Enumeration Date: 08/07/2023
  • Last Update Date: 08/07/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5395108757
  • Enrollment ID: I20230831004321

Medical Identifiers

Medical identifiers for Naomi Susan Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1013699131NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 1128446 (Texas)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. Naomi Susan Wallace allows following entities to bill medicare on her behalf.
Entity NameEtmc Physician Group, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609382662
PECOS PAC ID: 4486915600
Enrollment ID: O20180305002106

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. Naomi Susan 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 AddressPractice Location Address
Naomi Susan Wallace, NP
912 S Fleishel Ave,
Tyler, TX 75701-2018

Ph: (903) 592-6901		Naomi Susan Wallace, NP
912 S Fleishel Ave,
Tyler, TX 75701-2018

Ph: (903) 592-6901

Reviews and Comments


Nurse Practitioner Nurses in Tyler, TX

Brandi Dunford, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 910 E Houston St Ste 330, Tyler, TX 75702
Phone: 903-606-7995    
Jacob G Thoele, AGACNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 910 E Houston St Ste 550, Tyler, TX 75702
Phone: 903-606-8718    Fax: 903-606-1218
Abram Ambriz, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2608 Mcdonald Rd, Tyler, TX 75701
Phone: 903-595-5514    Fax: 903-262-3715
Anna Elise Fenton, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 6210 S Broadway Ave, Tyler, TX 75703
Phone: 903-579-2700    Fax: 903-579-2799
Mary Anne Fitzgerald, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 815 N Broadway Ave, Tyler, TX 75702
Phone: 903-535-0023    Fax: 903-535-0052
Rendall Northcutt, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 11937 Us Highway 271, Tyler, TX 75708
Phone: 903-877-7200    Fax: 903-877-5080
Kinsey Henry, MSN, APRN, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1720 S Beckham Ave, Tyler, TX 75701
Phone: 903-630-6211    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.