Savannah Lyn Wallace, OTR/L in Columbia, MO - Medicare Occupational Therapist Provider

Savannah Lyn Wallace, OTR/L is a medicare enrolled "Occupational Therapist" provider in Columbia, Missouri. Her current practice location is 1818 W Worley St, Columbia, Missouri. You can reach out to her office (for appointments etc.) via phone at (573) 214-3400.

Savannah Lyn Wallace is licensed to practice in Missouri (license number 2024001847) 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 1851159065.

Contact Information

	Savannah Lyn Wallace, OTR/L
	1818 W Worley St, Columbia, MO 65203-1038
	(573) 214-3400
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Savannah Lyn Wallace
Gender	Female
Speciality	Occupational Therapist
Location	1818 W Worley St, Columbia, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1851159065
Provider Enumeration Date: 03/12/2024
Last Update Date: 03/12/2024

Medicare PECOS Information:

PECOS PAC ID: 1254870843
Enrollment ID: I20240827003315

Medical Identifiers

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

Identifier	Type	State	Issuer
1851159065	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	2024001847 (Missouri)	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. Savannah Lyn Wallace allows following entities to bill medicare on her behalf.

Provider Name	Athletico Ltd
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1114449857 PECOS PAC ID: 4789602681 Enrollment ID: O20171211002357

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. Savannah Lyn 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
Savannah Lyn Wallace, OTR/L 1294 Commons Loop, Fulton, MO 65251-1456 Ph: (618) 340-5787	Savannah Lyn Wallace, OTR/L 1818 W Worley St, Columbia, MO 65203-1038 Ph: (573) 214-3400

Reviews and Comments

Occupational Therapist in Columbia, MO

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Savannah Lyn Wallace, OTR/L - Medicare Occupational Therapist in Columbia, MO