Alexis Nicole Wallace, MD is a medicare enrolled "Internal Medicine" physician in 1120 15th St, Georgia. She went to University Of South Carolina School Of Medicine and graduated in 2020 and has 5 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Muscogee Hospitalist Services, Llc and her current practice location is
Augusta University Medical Center, 1120 15th St, Georgia. You can reach out to her office (for appointments etc.) via phone at
(706) 721-2273.
Alexis Nicole Wallace is licensed to practice in Georgia (license number 12864) 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 1245856822.
Physician's Profile
| Full Name | Alexis Nicole Wallace |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Experience | 5 Years |
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| Location | Augusta University Medical Center, 1120 15th St, Georgia |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Alexis Nicole Wallace attended and graduated from University Of South Carolina School Of Medicine in 2020
NPI Data:
- NPI Number: 1245856822
- Provider Enumeration Date: 06/19/2020
- Last Update Date: 12/15/2021
Medicare PECOS Information:
- PECOS PAC ID: 6002217619
- Enrollment ID: I20241002000699
Medical Identifiers
Medical identifiers for Alexis Nicole Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1245856822 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | LL84507 (South Carolina) | Secondary |
| 207R00000X | Internal Medicine | 12864 (Georgia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Muscogee Hospitalist Services, Llc | 8921368564 | 35 |
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. Alexis Nicole Wallace allows following entities to bill medicare on her behalf.
| Entity Name | Southeastern Hospitalist Services Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003280108
PECOS PAC ID: 3476855420
Enrollment ID: O20160107001140 |
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| Entity Name | Muscogee Hospitalist Services, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1639681851
PECOS PAC ID: 8921368564
Enrollment ID: O20180130003094 |
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| Entity Name | Benning Hospitalist Services Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1215442173
PECOS PAC ID: 5698038479
Enrollment ID: O20180409000613 |
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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. Alexis Nicole 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 |
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Alexis Nicole Wallace, MD
Internal Medicine Residency 1120 15th St,
Augusta, GA 30912-0001
Ph: (706) 721-2273 | Alexis Nicole Wallace, MD
Augusta University Medical Center,
1120 15th St, GA 30912
Ph: (706) 721-2273 |
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