Dr Neil D Wallen, MD is a medicare enrolled "Allergy & Immunology - Allergy" physician in Bristol, Tennessee. His current practice location is
933 Highway 126, Bristol, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(423) 844-7000.
Dr Neil D Wallen is licensed to practice in Tennessee (license number MD0000017754) 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 1326043373.
Physician's Profile
| Full Name | Dr Neil D Wallen |
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| Gender | Male |
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| Speciality | Allergy & Immunology - Allergy |
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| Location | 933 Highway 126, Bristol, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1326043373
- Provider Enumeration Date: 06/16/2005
- Last Update Date: 09/24/2009
Medicare PECOS Information:
- PECOS PAC ID: 0749366987
- Enrollment ID: I20080327000640
Medical Identifiers
Medical identifiers for Dr Neil D Wallen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1326043373 | NPI | - | NPPES |
| 1326043373 | Medicaid | VA | |
| 006002188 | Medicaid | VA | |
| 1510634 | Medicaid | TN | |
| 3032572 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207KA0200X | Allergy & Immunology - Allergy | MD0000017754 (Tennessee) | 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. Dr Neil D Wallen allows following entities to bill medicare on his behalf.
| Entity Name | Holston Medical Group Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1831110667
PECOS PAC ID: 8224935754
Enrollment ID: O20031216000416 |
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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 Neil D Wallen 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 Neil D Wallen, MD
Po Box 9,
Kingsport, TN 37662-0009
Ph: (423) 844-7000 | Dr Neil D Wallen, MD
933 Highway 126,
Bristol, TN 37620-3310
Ph: (423) 844-7000 |
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