Stacey Wallace, OTRL in Midland, MI - Medicare Occupational Therapist Provider

Stacey Wallace, OTRL is a medicare enrolled "Occupational Therapist" provider in Midland, Michigan. Her current practice location is 5600 Waldo Ave, Midland, Michigan. You can reach out to her office (for appointments etc.) via phone at (989) 575-3255.

Stacey Wallace is licensed to practice in Michigan (license number 5201011236) 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 1043951957.

Contact Information

	Stacey Wallace, OTRL
	5600 Waldo Ave, Midland, MI 48642-6438
	(989) 575-3255
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Stacey Wallace
Gender	Female
Speciality	Occupational Therapist
Location	5600 Waldo Ave, Midland, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043951957
Provider Enumeration Date: 04/05/2022
Last Update Date: 04/05/2022

Medicare PECOS Information:

PECOS PAC ID: 6709273493
Enrollment ID: I20220427002614

Medical Identifiers

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

Identifier	Type	State	Issuer
1043951957	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	5201011236 (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. Stacey Wallace allows following entities to bill medicare on her behalf.

Provider Name	Legacy Healthcare Services Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1942829064 PECOS PAC ID: 2163339722 Enrollment ID: O20200618000474

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. Stacey 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
Stacey Wallace, OTRL 3326 Binscarth Ave, Saginaw, MI 48602-3203 Ph: (989) 327-9967	Stacey Wallace, OTRL 5600 Waldo Ave, Midland, MI 48642-6438 Ph: (989) 575-3255

Reviews and Comments

Occupational Therapist in Midland, MI

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Stacey Wallace, OTRL - Medicare Occupational Therapist in Midland, MI