Lydia Wallace, in Albuquerque, NM - Medicare Emergency Medicine

Lydia Wallace, is a medicare enrolled "Emergency Medicine" physician in Albuquerque, New Mexico. Her current practice location is 101 Hospital Loop Ne, Albuquerque, New Mexico. You can reach out to her office (for appointments etc.) via phone at (615) 928-6268.

Lydia Wallace is licensed to practice in New Mexico (license number MD2019-0840) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1417344581.

Contact Information

	Lydia Wallace,
	101 Hospital Loop Ne, Albuquerque, NM 87109-2129
	(615) 928-6268
	Not Available

Map and Direction

Physician's Profile

Full Name	Lydia Wallace
Gender	Female
Speciality	Emergency Medicine
Location	101 Hospital Loop Ne, Albuquerque, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417344581
Provider Enumeration Date: 04/16/2015
Last Update Date: 05/06/2020

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

Entity Name	App Of New Mexico Ed Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891169942 PECOS PAC ID: 7416259445 Enrollment ID: O20160108000220

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

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, 20 York St, New Haven, CT 06510-3220 Ph: (203) 688-4242	Lydia Wallace, 101 Hospital Loop Ne, Albuquerque, NM 87109-2129 Ph: (615) 928-6268

Reviews and Comments

Emergency Medicine Doctors in Albuquerque, NM

Darren M Shafer, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: Pmg Emergency Medicine, 1101 Central Se, Albuquerque, NM 87106 Phone: 505-841-1125 Fax: 505-841-1737
Jessica Mitchell, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 University Of New Mexico, Department Of Emergency Medicine Msc 11 6025, Albuquerque, NM 87131 Phone: 505-272-5062
Nicholas Weiss, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2211 Lomas Blvd Ne, Albuquerque, NM 87106 Phone: 505-272-5062
Matthew D Poage, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 5400 Gibson Blvd Se, Albuquerque, NM 87108 Phone: 904-805-1300 Fax: 904-805-1302
Matthew Wilks, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: Unm Department Of Emergency Medicine Msc11-6025, 1 University Of New Mexico, Albuquerque, NM 87131 Phone: 505-272-5062 Fax: 505-925-7290
Mr. Kyle I Schoenberger, NP Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3820 Commons Ave Ne, Albuquerque, NM 87109 Phone: 505-343-1711 Fax: 505-343-1862
Daniel M. Gee, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6400 Paseo Del Norte Blvd Ne, Albuquerque, NM 87113 Phone: 505-596-2100 Fax: 505-596-2180

Lydia Wallace, - Medicare Emergency Medicine in Albuquerque, NM