Marykelly Wallace, MOTR/L in Detroit, MI - Medicare Occupational Therapist Provider

Marykelly Wallace, MOTR/L is a medicare enrolled "Occupational Therapist" provider in Detroit, Michigan. Her current practice location is 7800 W Outer Dr Ste 300, Detroit, Michigan. You can reach out to her office (for appointments etc.) via phone at (586) 204-5560.

Marykelly Wallace is licensed to practice in Michigan (license number 5201010849) 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 1598372187.

Contact Information

	Marykelly Wallace, MOTR/L
	7800 W Outer Dr Ste 300, Detroit, MI 48235-3458
	(586) 204-5560
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Marykelly Wallace
Gender	Female
Speciality	Occupational Therapist
Location	7800 W Outer Dr Ste 300, Detroit, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1598372187
Provider Enumeration Date: 09/28/2020
Last Update Date: 09/28/2020

Medicare PECOS Information:

PECOS PAC ID: 6305253402
Enrollment ID: I20210407000545

Medical Identifiers

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

Identifier	Type	State	Issuer
1598372187	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	5201010849 (Michigan)	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. Marykelly Wallace allows following entities to bill medicare on her behalf.

Provider Name	Psygenics Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1669736104 PECOS PAC ID: 9436465820 Enrollment ID: O20150831002063

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. Marykelly 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
Marykelly Wallace, MOTR/L 27085 Gratiot Ave Ste 101, Roseville, MI 48066-2984 Ph: () -	Marykelly Wallace, MOTR/L 7800 W Outer Dr Ste 300, Detroit, MI 48235-3458 Ph: (586) 204-5560

Reviews and Comments

Occupational Therapist in Detroit, MI

Mr. Mohamed Ibrahim Bazzi, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3990 John R St, Detroit, MI 48201 Phone: 810-333-1822
Molly Ann James, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 11000 W Mcnichols Rd Ste 320, Detroit, MI 48221 Phone: 313-340-4442
Jarin Jaigirdar, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 9500 Grand River Ave, Detroit, MI 48204 Phone: 313-491-7920
Ms. Taleshia Moss, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 2295 Chene, Detroit, MI 48207 Phone: 313-923-5816
Ms. Alanna Giordano, OT Occupational Therapist Medicare: Medicare Enrolled Practice Location: 261 Mack Ave, Detroit, MI 48201 Phone: 313-745-1100
Madison Muir, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 261 Mack Ave, Detroit, MI 48201 Phone: 313-745-1203
Kelsey Jackson, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3901 Beaubien St, Detroit, MI 48201 Phone: 816-805-0963

Marykelly Wallace, MOTR/L - Medicare Occupational Therapist in Detroit, MI