Lodica Wallace, in Commerce Twp, MI - Medicare Nurse Practitioner

Lodica Wallace, is a medicare enrolled "Nurse Practitioner - Family" in Commerce Twp, Michigan. Her current practice location is 790 Drakeshire Dr, Commerce Twp, Michigan. You can reach out to her office (for appointments etc.) via phone at (248) 910-2762.

Lodica Wallace is licensed to practice in Michigan (license number 2018023394) 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 1114587557.

Contact Information

	Lodica Wallace,
	790 Drakeshire Dr, Commerce Twp, MI 48390-2981
	(248) 910-2762
	Not Available

Map and Direction

Provider's Profile

Full Name	Lodica Wallace
Gender	Female
Speciality	Nurse Practitioner - Family
Location	790 Drakeshire Dr, Commerce Twp, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114587557
Provider Enumeration Date: 06/18/2019
Last Update Date: 06/18/2019

Medicare PECOS Information:

PECOS PAC ID: 2163895699
Enrollment ID: I20230303002024

Medical Identifiers

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

Identifier	Type	State	Issuer
1114587557	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	2018023394 (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. Lodica Wallace allows following entities to bill medicare on her behalf.

Entity Name	Ascension Providence Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942265236 PECOS PAC ID: 6103738703 Enrollment ID: O20031103000326

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. Lodica 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
Lodica Wallace, 790 Drakeshire Dr, Commerce Twp, MI 48390-2981 Ph: () -	Lodica Wallace, 790 Drakeshire Dr, Commerce Twp, MI 48390-2981 Ph: (248) 910-2762

Reviews and Comments

Nurse Practitioner Nurses in Commerce Twp, MI

Patricia Ann Atkins, NNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5473 Hillsboro Ct, Commerce Twp, MI 48382 Phone: 847-530-3353
Tobechukwu Anthonia Unaegbu, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2852 Ivy Hill Dr, Commerce Twp, MI 48382 Phone: 248-574-1878
Lindsay Rutland, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8896 Commerce Rd Ste 5, Commerce Twp, MI 48382 Phone: 248-360-9241
Mrs. Lindsay Anne Brossy, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8906 Commerce Rd Unit 5, Commerce Twp, MI 48382 Phone: 248-363-5555 Fax: 248-926-9112

Lodica Wallace, - Medicare Nurse Practitioner in Commerce Twp, MI