Ryan Wallace, NP in Lake Katrine, NY - Medicare Nurse Practitioner

Ryan Wallace, NP is a medicare enrolled "Nurse Practitioner - Adult Health" in Lake Katrine, New York. His current practice location is 300 Grant Ave, Lake Katrine, New York. You can reach out to his office (for appointments etc.) via phone at (845) 366-3500.

Ryan Wallace is licensed to practice in New York (license number 310895) 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 1689389868.

Contact Information

	Ryan Wallace, NP
	300 Grant Ave, Lake Katrine, NY 12449-5340
	(845) 366-3500
	Not Available

Map and Direction

Provider's Profile

Full Name	Ryan Wallace
Gender	Male
Speciality	Nurse Practitioner - Adult Health
Location	300 Grant Ave, Lake Katrine, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1689389868
Provider Enumeration Date: 01/23/2023
Last Update Date: 07/07/2023

Medicare PECOS Information:

PECOS PAC ID: 2466416813
Enrollment ID: I20230419001284

Medical Identifiers

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

Identifier	Type	State	Issuer
1689389868	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	170263 (Connecticut)	Secondary
163W00000X	Registered Nurse	639923 (New York)	Secondary
363L00000X	Nurse Practitioner	10962 (Connecticut)	Secondary
363LA2200X	Nurse Practitioner - Adult Health	310895 (New York)	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. Ryan Wallace allows following entities to bill medicare on his behalf.

Entity Name	Peyman Younesi Md Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891053328 PECOS PAC ID: 4981860202 Enrollment ID: O20120731000499

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. Ryan 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
Ryan Wallace, NP 6136 170th St Apt M4, Fresh Meadows, NY 11365-1957 Ph: (845) 297-3913	Ryan Wallace, NP 300 Grant Ave, Lake Katrine, NY 12449-5340 Ph: (845) 366-3500

Reviews and Comments

Nurse Practitioner Nurses in Lake Katrine, NY

Mr. Mathew Scott Owitz, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1561 Route 9w, Lake Katrine, NY 12449 Phone: 845-231-5600 Fax: 845-331-7160
Mrs. Nicola Richards, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1561 Route 9w, Lake Katrine, NY 12449 Phone: 845-231-5600
Remiya Kurian, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 315 Grant Ave, Lake Katrine, NY 12449 Phone: 845-339-2525
Maureen Mcnamara, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 300 Grant Ave, Lake Katrine, NY 12449 Phone: 845-336-3500 Fax: 845-382-1417
Cynthia Pascaretti, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1561 Route 9w, Lake Katrine, NY 12449 Phone: 845-231-5600 Fax: 845-202-6005
Nila Gala Belmar, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 300 Grant Ave, Lake Katrine, NY 12449 Phone: 845-336-3500 Fax: 845-336-7899
Barbara N Elkins, ANP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 Commons Dr, Lake Katrine, NY 12449 Phone: 845-336-6666

Ryan Wallace, NP - Medicare Nurse Practitioner in Lake Katrine, NY