Lydia Wallace, in Brockton, MA - Medicare Emergency Medicine

Lydia Wallace, is a medicare enrolled "Emergency Medicine" physician in Brockton, Massachusetts. She went to Tufts University School Of Medicine and graduated in 2015 and has 10 years of diverse experience with area of expertise as Emergency Medicine. She is a member of the group practice Emergency Staffing Solutions Inc and her current practice location is 235 N Pearl St, Brockton, Massachusetts. You can reach out to her office (for appointments etc.) via phone at (617) 414-5405.

Lydia Wallace is licensed to practice in Massachusetts (license number 1024211) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1417344581.

Contact Information

	Lydia Wallace,
	235 N Pearl St, Brockton, MA 02301-1794
	(617) 414-5405
	Not Available

Map and Direction

Physician's Profile

Full Name	Lydia Wallace
Gender	Female
Speciality	Emergency Medicine
Experience	10 Years
Location	235 N Pearl St, Brockton, Massachusetts
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Lydia Wallace attended and graduated from Tufts University School Of Medicine in 2015

NPI Data:

NPI Number: 1417344581
Provider Enumeration Date: 04/16/2015
Last Update Date: 08/02/2025

Medicare PECOS Information:

PECOS PAC ID: 4688989742
Enrollment ID: I20191022000938

Medical Identifiers

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

Identifier	Type	State	Issuer
1417344581	NPI	-	NPPES
MD2019-08	Other	NM	LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	MD2019-0840 (New Mexico)	Secondary
207P00000X	Emergency Medicine	1024211 (Massachusetts)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Lovelace Women's Hospital	Albuquerque, NM	Hospital
Lovelace Westside Hospital	Albuquerque, NM	Hospital
Lovelace Medical Center	Albuquerque, NM	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Emergency Staffing Solutions Inc	9830001650	58

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. Lydia Wallace allows following entities to bill medicare on her behalf.

Entity Name	Emergency Staffing Solutions Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477590974 PECOS PAC ID: 9830001650 Enrollment ID: O20070724000197

Entity Name	Southwest Emergency Medical Associates Of Nm Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720505571 PECOS PAC ID: 8426324294 Enrollment ID: O20171023001270

Entity Name	Las Cruces Hb Medical Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598446171 PECOS PAC ID: 8123473600 Enrollment ID: O20231018003832

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. Lydia 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
Lydia Wallace, 960 Massachusetts Ave Ste 2, Boston, MA 02118-2690 Ph: (617) 414-5405	Lydia Wallace, 235 N Pearl St, Brockton, MA 02301-1794 Ph: (617) 414-5405

Reviews and Comments

Emergency Medicine Doctors in Brockton, MA

Samantha A Siegel, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 N Pearl St, Brockton, MA 02301 Phone: 508-427-3000
Luis E. Ortiz, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 680 Centre St, Brockton, MA 02302 Phone: 508-941-7000
Dr. Stephen J Simon, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 680 Centre St, Brockton, MA 02302 Phone: 508-941-7000
Dr. John Kyle Volpe, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 680 Centre St, Brockton, MA 02302 Phone: 508-941-7200
Grant Wei, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 680 Centre St, Dept. Of Emergency Medicine, Brockton, MA 02302 Phone: 508-941-7400
Jacob F. Kallenberg, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 N Pearl St, Brockton, MA 02301 Phone: 508-427-3075
Daniel Werzanski, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 680 Centre St, Brockton, MA 02302 Phone: 508-941-7000

Lydia Wallace, - Medicare Emergency Medicine in Brockton, MA