Kelly Wallace, RPT in Choctaw, OK - Medicare Physical Therapy Provider

Kelly Wallace, RPT is a medicare enrolled "Physical Therapist" provider in Choctaw, Oklahoma. She graduated from medical school in 1995 and has 29 years of diverse experience with area of expertise as Physical Therapy. She is a member of the group practice Choctaw Physical Therapy Llc, Cutting Edge Physical Therapy, Pllc and her current practice location is 13390 Ne 23rd St, Choctaw, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (405) 769-5555.

Kelly Wallace is licensed to practice in Oklahoma (license number PT2460) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1184696023.

Contact Information

	Kelly Wallace, RPT
	13390 Ne 23rd St, Choctaw, OK 73020-8622
	(405) 769-5555
	(405) 769-5558

Map and Direction

Healthcare Provider's Profile

Full Name	Kelly Wallace
Gender	Female
Speciality	Physical Therapy
Experience	29 Years
Location	13390 Ne 23rd St, Choctaw, Oklahoma
Accepts Medicare Assignments	May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kelly Wallace graduated from medical school in 1995

NPI Data:

NPI Number: 1184696023
Provider Enumeration Date: 02/05/2006
Last Update Date: 04/27/2015

Medicare PECOS Information:

PECOS PAC ID: 0941343289
Enrollment ID: I20100416000047

Medical Identifiers

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

Identifier	Type	State	Issuer
1184696023	NPI	-	NPPES
200552760A	Medicaid	OK

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT2460 (Oklahoma)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Choctaw Physical Therapy Llc	6305989641	2
Cutting Edge Physical Therapy, Pllc	9537380837	2

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. Kelly Wallace allows following entities to bill medicare on her behalf.

Provider Name	Choctaw Physical Therapy Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1093938383 PECOS PAC ID: 6305989641 Enrollment ID: O20100208000841

Provider Name	Cutting Edge Physical Therapy, Pllc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1508272006 PECOS PAC ID: 9537380837 Enrollment ID: O20141030002169

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. Kelly 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
Kelly Wallace, RPT 13390 Ne 23rd St, Choctaw, OK 73020-8622 Ph: (405) 769-5555	Kelly Wallace, RPT 13390 Ne 23rd St, Choctaw, OK 73020-8622 Ph: (405) 769-5555

Reviews and Comments

Physical Therapist in Choctaw, OK

Cathy Lynan Trout, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 818 Silver Tree Dr, Choctaw, OK 73020 Phone: 907-355-0602
Jeffrey Michael Hogan, PT, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 14890 Se 29th St, Choctaw, OK 73020 Phone: 405-390-1731 Fax: 405-390-1981
Kayla Volk, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 14890 Se 29th St Ste 101, Choctaw, OK 73020 Phone: 405-390-1731
Home Therapy Services Pllc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 12109 Se 29th St, Choctaw, OK 73020 Phone: 405-990-1025 Fax: 405-455-3717
Choctaw-nicoma Park Schools Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 12880 Ne 10th St, Choctaw, OK 73020 Phone: 405-769-8389 Fax: 405-769-9821
Oklahoma Physical Therapy Choctaw Physical Therapist Medicare: Medicare Enrolled Practice Location: 1960 Harper St, Suite B, Choctaw, OK 73020 Phone: 405-281-5785 Fax: 405-281-5786

Kelly Wallace, RPT - Medicare Physical Therapist in Choctaw, OK