Donald R Wallace, MD - Medicare Emergency Medicine in Peoria, IL

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Donald R Wallace, MD is a medicare enrolled "Emergency Medicine" physician in Peoria, Illinois. His current practice location is 5114 N Glen Park Place Rd, Peoria, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 683-6600.

Donald R Wallace is licensed to practice in Illinois (license number 036-077680) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1700899788.

Contact Information

Donald R Wallace, MD
5114 N Glen Park Place Rd,
Peoria, IL 61614-4686
(309) 683-6600
Not Available

Map and Direction




Physician's Profile

Full NameDonald R Wallace
GenderMale
SpecialityEmergency Medicine
Location5114 N Glen Park Place Rd, Peoria, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1700899788
  • Provider Enumeration Date: 08/14/2006
  • Last Update Date: 07/29/2010
  Medicare PECOS Information:
  • PECOS PAC ID: 5890722508
  • Enrollment ID: I20050725000888

Medical Identifiers

Medical identifiers for Donald R Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1700899788NPI-NPPES
036077680MedicaidIL
809840034OtherILMEDICARE INDIVIDUAL PTAN
800810OtherMEDICARE GROUP NO.
809840OtherILMEDICARE GROUP PTAN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 036-077680 (Illinois)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. Donald R Wallace allows following entities to bill medicare on his behalf.
Entity NameSt. Joseph Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871547414
PECOS PAC ID: 8921901620
Enrollment ID: O20040129001106
Entity NameSaint Francis Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023062312
PECOS PAC ID: 9032021258
Enrollment ID: O20080303000228

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. Donald R 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 AddressPractice Location Address
Donald R Wallace, MD
5114 N Glen Park Place Rd,
Peoria, IL 61614-4686

Ph: (309) 683-6600		Donald R Wallace, MD
5114 N Glen Park Place Rd,
Peoria, IL 61614-4686

Ph: (309) 683-6600

Reviews and Comments


Emergency Medicine Doctors in Peoria, IL

Austin J Lamb, M.D.
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Practice Location: 530 N.e. Glen Oak Avenue, Osf St. Francis, Emergency Medicine Residency Program, Peoria, IL 61637
Phone: 309-655-7257    
Philip A Fifield, M.D.
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Medicare: Not Enrolled in Medicare
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-2553    Fax: 309-655-2602
Brittain Utah Ladd, DO
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Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-2553    Fax: 309-655-2602
Dr. Anthony J Buecker, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636
Phone: 309-672-5500    
Dr. Mark Phillip Gaudio, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-6710    
Michael M Raso, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1115 N Bourland Ave, Peoria, IL 61606
Phone: 309-264-0730    
Joseph Devito, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave Bldg Room2620, Peoria, IL 61637
Phone: 309-655-6710    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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