Mary Elise Waller, PT, DPT in Southlake, TX - Medicare Physical Therapist Provider

Mary Elise Waller, PT, DPT is a medicare enrolled "Physical Therapist - Orthopedic" provider in Southlake, Texas. Her current practice location is 2419 W Southlake Blvd Ste 100, Southlake, Texas. You can reach out to her office (for appointments etc.) via phone at (469) 535-6842.

Mary Elise Waller is licensed to practice in Texas (license number 1342742) 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 1649865692.

Contact Information

	Mary Elise Waller, PT, DPT
	2419 W Southlake Blvd Ste 100, Southlake, TX 76092-1506
	(469) 535-6842
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mary Elise Waller
Gender	Female
Speciality	Physical Therapist - Orthopedic
Location	2419 W Southlake Blvd Ste 100, Southlake, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1649865692
Provider Enumeration Date: 03/02/2021
Last Update Date: 03/02/2021

Medicare PECOS Information:

PECOS PAC ID: 8325457880
Enrollment ID: I20210513000417

Medical Identifiers

Medical identifiers for Mary Elise Waller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1649865692	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2251X0800X	Physical Therapist - Orthopedic	1342742 (Texas)	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. Mary Elise Waller allows following entities to bill medicare on her behalf.

Provider Name	Doctx3 Pllc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1467808618 PECOS PAC ID: 1355620055 Enrollment ID: O20161121002559

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. Mary Elise Waller 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
Mary Elise Waller, PT, DPT 5828 Colhurst St, Dallas, TX 75230-5020 Ph: (214) 926-6041	Mary Elise Waller, PT, DPT 2419 W Southlake Blvd Ste 100, Southlake, TX 76092-1506 Ph: (469) 535-6842

Reviews and Comments

Physical Therapist in Southlake, TX

Erin Goebel, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1545 E Southlake Blvd Ste 100, Southlake, TX 76092 Phone: 817-442-9300 Fax: 817-416-0108
Mrs. Lisa Alice Redding, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1940 E State Highway 114, Suite 150, Southlake, TX 76092 Phone: 817-424-3668 Fax: 817-442-8637
Whitney Holmans, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1545 E Southlake Blvd, Suite 100, Southlake, TX 76092 Phone: 817-442-9300 Fax: 682-651-1909
Jennifer Merimonti, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 101 Watermere Dr., Southlake, TX 76092 Phone: 817-431-8668
Kara Edgerton, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2813 W Southlake Blvd, Suite 110, Southlake, TX 76092 Phone: 817-310-8780 Fax: 817-310-8781
Raphael Augustus Sadiwa, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 180 State St Ste 225, Southlake, TX 76092 Phone: 866-839-6979
Theresa J Adame-brooks, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1545 E Southlake Blvd Ste 100, Southlake, TX 76092 Phone: 817-442-9300 Fax: 817-416-0108

Mary Elise Waller, PT, DPT - Medicare Physical Therapist in Southlake, TX