John T Wallace Ii, MD in Fort Bragg, CA - Medicare Internal Medicine

John T Wallace Ii, MD is a medicare enrolled "Internal Medicine" physician in Fort Bragg, California. His current practice location is 205 South St, Fort Bragg, California. You can reach out to his office (for appointments etc.) via phone at (707) 964-1251.

John T Wallace Ii is licensed to practice in California (license number G37773) 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 1023079803.

Contact Information

	John T Wallace Ii, MD
	205 South St, Fort Bragg, CA 95437-5540
	(707) 964-1251
	(707) 961-2722

Map and Direction

Physician's Profile

Full Name	John T Wallace Ii
Gender	Male
Speciality	Internal Medicine
Location	205 South St, Fort Bragg, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1023079803
Provider Enumeration Date: 03/31/2006
Last Update Date: 12/22/2011

Medicare PECOS Information:

PECOS PAC ID: 2961419536
Enrollment ID: I20060307000864

Medical Identifiers

Medical identifiers for John T Wallace Ii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1023079803	NPI	-	NPPES
00G377730	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	G37773 (California)	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. John T Wallace Ii allows following entities to bill medicare on his behalf.

Entity Name	Aretaeus Telemedicine Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548490261 PECOS PAC ID: 6002953635 Enrollment ID: O20091029000684

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. John T Wallace Ii 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
John T Wallace Ii, MD 205 South St, Fort Bragg, CA 95437-5540 Ph: (707) 964-1251	John T Wallace Ii, MD 205 South St, Fort Bragg, CA 95437-5540 Ph: (707) 964-1251

Reviews and Comments

Internal Medicine Doctors in Fort Bragg, CA

Dr. James William Swallow, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 721 River Drive, Suite A, Fort Bragg, CA 95437 Phone: 707-961-4631 Fax: 707-964-1192
Jason Kirkman, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 721 River Drive, Suite A, Fort Bragg, CA 95437 Phone: 707-961-4631 Fax: 707-964-1192
Kunal Om Goel, Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 700 River Dr, Fort Bragg, CA 95437 Phone: 707-961-4631
John Arthur Rochat, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 700 River Dr, Fort Bragg, CA 95437 Phone: 707-961-4922 Fax: 707-961-4900
Elizabeth Allan Khan, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 721 River Drive, Suite A, Fort Bragg, CA 95437 Phone: 707-961-4631 Fax: 707-964-1192
Richard Sacks-wilner, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 721 River Drive, Suite A, Fort Bragg, CA 95437 Phone: 707-964-7241

John T Wallace Ii, MD - Medicare Internal Medicine in Fort Bragg, CA