Kojo Wallace, MD in Lynchburg, VA

Kojo Wallace, MD is a medicare enrolled "Surgery - Trauma Surgery" physician in Lynchburg, Virginia. His current practice location is Centra Lynchburg General Hospital, 1901 Tate Springs Rd, Lynchburg, Virginia. You can reach out to his office (for appointments etc.) via phone at (434) 200-3000.

Kojo Wallace is licensed to practice in Virginia (license number 0101285554) 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 1720475866.

Contact Information

	Kojo Wallace, MD
	Centra Lynchburg General Hospital, 1901 Tate Springs Rd, Lynchburg, VA 24501
	(434) 200-3000
	Not Available

Map and Direction

Physician's Profile

Full Name	Kojo Wallace
Gender	Male
Speciality	Surgery - Trauma Surgery
Location	Centra Lynchburg General Hospital, Lynchburg, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720475866
Provider Enumeration Date: 04/15/2015
Last Update Date: 07/11/2025

Medicare PECOS Information:

PECOS PAC ID: 9830435411
Enrollment ID: I20211110001776

Medical Identifiers

Medical identifiers for Kojo Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720475866	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2086S0127X	Surgery - Trauma Surgery	0101285554 (Virginia)	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. Kojo Wallace allows following entities to bill medicare on his behalf.

Entity Name	North Shore-lij Medical Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262

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. Kojo 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
Kojo Wallace, MD 909 Station Way, Huntington Station, NY 11746-1971 Ph: () -	Kojo Wallace, MD Centra Lynchburg General Hospital, 1901 Tate Springs Rd, Lynchburg, VA 24501 Ph: (434) 200-3000

Reviews and Comments

Surgery Doctors in Lynchburg, VA

Dr. Lucius Dubignon Clay Iii, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1906 Thomson Dr, Lynchburg, VA 24501 Phone: 434-947-3950
Alex Hamilton, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 1901 Tate Springs Rd, Lynchburg, VA 24501 Phone: 434-200-3901
Dr. Amanda B Mcclung, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1906 Thomson Drive, Lynchburg, VA 24501 Phone: 434-947-3933 Fax: 434-947-3988
Dr. Clinton Steven Beverly, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1906 Thomson Drive, Central Virginia Surgery, Lynchburg, VA 24501 Phone: 434-947-3933 Fax: 434-947-3988
William L Kittrell Jr., MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1906 Thomson Dr, Central Virginia Surgery, Lynchburg, VA 24501 Phone: 434-947-3933 Fax: 434-947-3988
Dr. Albert Gordon Pavalonis, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2410 Atherholt Rd, Lynchburg, VA 24501 Phone: 434-200-5299 Fax: 434-200-2386
Dr. Ronald Gene Hill, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1900 Tate Springs Rd, Suite 3, Lynchburg, VA 24501 Phone: 434-947-3950 Fax: 434-947-5914

Kojo Wallace, MD - Medicare Surgery in Lynchburg, VA