Deanna Wallace, NP is a medicare enrolled "Nurse Practitioner - Family" physician in Urbana, Illinois. She graduated from medical school in 2016 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Carle Health Care Incorporated and her current practice location is
611 W Park, Fapc, Urbana, Illinois. You can reach out to her office (for appointments etc.) via phone at
(217) 902-6954.
Deanna Wallace is licensed to practice in Illinois (license number 209014278) 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 1609222579.
Physician's Profile
| Full Name | Deanna Wallace |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 9 Years |
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| Location | 611 W Park, Urbana, Illinois |
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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:
- Deanna Wallace graduated from medical school in 2016
NPI Data:
- NPI Number: 1609222579
- Provider Enumeration Date: 05/10/2016
- Last Update Date: 12/31/2024
Medicare PECOS Information:
- PECOS PAC ID: 5799074605
- Enrollment ID: I20160517000849
Medical Identifiers
Medical identifiers for Deanna Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609222579 | NPI | - | NPPES |
| $$$$$$$$$ | Medicaid | IL | |
| P01657319 | Other | IL | RAILROAD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 209.014278 (Illinois) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 209014278 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Carle Health Care Incorporated | 3577515774 | 912 |
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. Deanna Wallace allows following entities to bill medicare on her behalf.
| Entity Name | Carle Health Care Incorporated |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154653947
PECOS PAC ID: 3577515774
Enrollment ID: O20100513000829 |
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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. Deanna 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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Deanna Wallace, NP
611 W Park, Fapc,
Urbana, IL 61802
Ph: (217) 902-6954 | Deanna Wallace, NP
611 W Park, Fapc,
Urbana, IL 61802
Ph: (217) 902-6954 |
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