Amy D Wallis, FNP in Fort Madison, IA - Medicare Nurse Practitioner

Amy D Wallis, FNP is a medicare enrolled "Nurse Practitioner - Family" in Fort Madison, Iowa. She graduated from nursing school in 2005 and has 19 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Southeast Iowa Regional Medical Center Inc and her current practice location is 5409 Avenue O, Fort Madison, Iowa. You can reach out to her office (for appointments etc.) via phone at (319) 376-2134.

Amy D Wallis is licensed to practice in Iowa (license number 100507) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1275598864.

Contact Information

	Amy D Wallis, FNP
	5409 Avenue O, Fort Madison, IA 52627-9601
	(319) 376-2134
	(319) 376-2188

Map and Direction

Provider's Profile

Full Name	Amy D Wallis
Gender	Female
Speciality	Nurse Practitioner
Experience	19 Years
Location	5409 Avenue O, Fort Madison, Iowa
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Amy D Wallis graduated from nursing school in 2005

NPI Data:

NPI Number: 1275598864
Provider Enumeration Date: 04/18/2006
Last Update Date: 10/06/2011

Medicare PECOS Information:

PECOS PAC ID: 1052356490
Enrollment ID: I20050625000013

Medical Identifiers

Medical identifiers for Amy D Wallis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1275598864	NPI	-	NPPES
1275598864	Other	IA	WELLMARK BLUE CROSS BLUE SHIELD
1275598864	Medicaid	IA
P00456554	Other	IN	RAILROAD MEDICARE
200848020A	Medicaid	IN
CG3197	Other	IN	MEDCARE RAILROAD GROUP

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	71002282A (Indiana)	Secondary
363LF0000X	Nurse Practitioner - Family	100507 (Iowa)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Lee County Health Department	Fort madison, IA	Home health agency
Great River Medical Center	West burlington, IA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Southeast Iowa Regional Medical Center Inc	3870496417	189

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. Amy D Wallis allows following entities to bill medicare on her behalf.

Entity Name	Southeast Iowa Regional Medical Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1164433884 PECOS PAC ID: 3870496417 Enrollment ID: O20040130000139

Entity Name	Fort Madison Community Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083764393 PECOS PAC ID: 8729971841 Enrollment ID: O20040203001066

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. Amy D Wallis 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
Amy D Wallis, FNP 5409 Avenue O, Fort Madison, IA 52627-9601 Ph: (319) 376-2134	Amy D Wallis, FNP 5409 Avenue O, Fort Madison, IA 52627-9601 Ph: (319) 376-2134

Reviews and Comments

Nurse Practitioner Nurses in Fort Madison, IA

Mrs. Michelle Lynn Hornung, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5409 Avenue O, Fort Madison, IA 52627 Phone: 319-376-2134 Fax: 319-376-2188
Katrina Hotka-truempler, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5445 Avenue O, Fort Madison, IA 52627 Phone: 319-372-6530
Ms. Sara Marie Gudenkauf, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5409 Avenue O, Fort Madison, IA 52627 Phone: 319-376-2134 Fax: 319-376-2188
Kaitlyn Marie Fedler, DNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5445 Avenue O, Fort Madison, IA 52627 Phone: 319-759-4987
Carrie Skibba, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5409 Avenue O, Fort Madison, IA 52627 Phone: 319-376-2134 Fax: 319-376-2188
Susan J Holtkamp, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5409 Avenue O, Fort Madison, IA 52627 Phone: 319-376-2134 Fax: 319-376-2188

Amy D Wallis, FNP - Medicare Nurse Practitioner in Fort Madison, IA