Dr Andrew Waller, MD is a medicare enrolled "General Practice" physician in Abingdon, Virginia. He graduated from medical school in 1986 and has 40 years of diverse experience with area of expertise as Addiction Medicine. He is a member of the group practice Revida Recovery Centers Pc, Revida Recovery Centers Pc and his current practice location is
300 Valley St Ne, Abingdon, Virginia. You can reach out to his office (for appointments etc.) via phone at
(276) 206-8197.
Dr Andrew Waller is licensed to practice in Virginia (license number 0101257630) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1053334219.
Physician's Profile
| Full Name | Dr Andrew Waller |
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| Gender | Male |
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| Speciality | Addiction Medicine |
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| Experience | 40 Years |
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| Location | 300 Valley St Ne, Abingdon, Virginia |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Andrew Waller graduated from medical school in 1986
NPI Data:
- NPI Number: 1053334219
- Provider Enumeration Date: 07/26/2006
- Last Update Date: 02/25/2026
Medicare PECOS Information:
- PECOS PAC ID: 8628147550
- Enrollment ID: I20191002001323
Medical Identifiers
Medical identifiers for Dr Andrew Waller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053334219 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | 0101257630 (Virginia) | Secondary |
| 208D00000X | General Practice | 0101257630 (Virginia) | Primary |
| 207RA0401X | Internal Medicine - Addiction Medicine | 0101257630 (Virginia) | Secondary |
| 208D00000X | General Practice | 51691 (Tennessee) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Revida Recovery Centers Pc | 1153657473 | 31 |
| Revida Recovery Centers Pc | 1153657473 | 31 |
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. Dr Andrew Waller allows following entities to bill medicare on his behalf.
| Entity Name | Revida Recovery Centers Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013483486
PECOS PAC ID: 1153657473
Enrollment ID: O20190904001928 |
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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. Dr Andrew Waller 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 |
|---|
Dr Andrew Waller, MD
300 Valley St Ne,
Abingdon, VA 24210-2912
Ph: (276) 206-8197 | Dr Andrew Waller, MD
300 Valley St Ne,
Abingdon, VA 24210-2912
Ph: (276) 206-8197 |
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