Douglas Wallace, in Weehawken, NJ - Medicare Physical Therapist Provider

Douglas Wallace, is a medicare enrolled "Physical Therapist" provider in Weehawken, New Jersey. His current practice location is 36 Hudson Pl, Weehawken, New Jersey. You can reach out to his office (for appointments etc.) via phone at (201) 522-6474.

Douglas Wallace is licensed to practice in New Jersey (license number 40QA00655300) 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 1356921118.

Contact Information

	Douglas Wallace,
	36 Hudson Pl, Weehawken, NJ 07086-7013
	(201) 522-6474
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Douglas Wallace
Gender	Male
Speciality	Physical Therapist
Location	36 Hudson Pl, Weehawken, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1356921118
Provider Enumeration Date: 04/14/2021
Last Update Date: 04/14/2021

Medicare PECOS Information:

PECOS PAC ID: 2668825696
Enrollment ID: I20240125004749

Medical Identifiers

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

Identifier	Type	State	Issuer
1356921118	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	40QA00655300 (New Jersey)	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. Douglas Wallace allows following entities to bill medicare on his behalf.

Provider Name	Healthpro Heritage Rehab & Fitness Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1689022295 PECOS PAC ID: 6507832573 Enrollment ID: O20160919002691

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. Douglas 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
Douglas Wallace, 36 Hudson Pl, Weehawken, NJ 07086-7013 Ph: (201) 522-6474	Douglas Wallace, 36 Hudson Pl, Weehawken, NJ 07086-7013 Ph: (201) 522-6474

Reviews and Comments

Physical Therapist in Weehawken, NJ

Elizabeth Mancini, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 Ave At Port Imperial Blvd Ste 110, Weehawken, NJ 07086 Phone: 201-272-9400
Jaclyn H Fulop, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 500 Ave At Port Imperial Blvd Ste 110, Weehawken, NJ 07086 Phone: 201-272-9400 Fax: 201-272-9402
Andrew Pearson, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4100 Park Ave Ste 8b, Weehawken, NJ 07086 Phone: 201-271-0800
Tony Emadzadeh, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 500 Ave At Port Imperial Blvd Ste 110, Weehawken, NJ 07086 Phone: 201-272-9400
Pallavi Shah, PHYSICAL THERAPIST Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 359 Park Ave, Weehawken, NJ 07086 Phone: 703-944-4257
One Hudson Physical Therapy Physical Therapist Medicare: Medicare Enrolled Practice Location: 359 Park Ave, Weehawken, NJ 07086 Phone: 703-944-4257

Douglas Wallace, - Medicare Physical Therapist in Weehawken, NJ