Mikaila Wallace, DO - Medicare Family Medicine in Maryville, MO

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Mikaila Wallace, DO is a medicare enrolled "Family Medicine" physician in Maryville, Missouri. Her current practice location is 2016 S Main St, Maryville, Missouri. You can reach out to her office (for appointments etc.) via phone at (660) 562-2525.

Mikaila Wallace is licensed to practice in Missouri (license number 2024030678) 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 1023687217.

Contact Information

Mikaila Wallace, DO
2016 S Main St,
Maryville, MO 64468-2655
(660) 562-2525
(660) 562-7996

Map and Direction




Physician's Profile

Full NameMikaila Wallace
GenderFemale
SpecialityFamily Medicine
Location2016 S Main St, Maryville, Missouri
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1023687217
  • Provider Enumeration Date: 06/22/2021
  • Last Update Date: 05/12/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 2466840996
  • Enrollment ID: I20241003002552

Medical Identifiers

Medical identifiers for Mikaila Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023687217NPI-NPPES
200147246MedicaidMO
470553011-00MedicaidNE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 2024030678 (Missouri)Primary
207Q00000XFamily Medicine TEP9082 (Nebraska)Secondary

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. Mikaila Wallace allows following entities to bill medicare on her behalf.
Entity NameMosaic Medical Center - Maryville
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184189797
PECOS PAC ID: 3678813896
Enrollment ID: O20190405001537

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. Mikaila 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 AddressPractice Location Address
Mikaila Wallace, DO
2016 S Main St,
Maryville, MO 64468-2655

Ph: (660) 562-2525		Mikaila Wallace, DO
2016 S Main St,
Maryville, MO 64468-2655

Ph: (660) 562-2525

Reviews and Comments


Family Medicine Doctors in Maryville, MO

Dr. Sally A. Bomar, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2016 S Main St, Maryville, MO 64468
Phone: 660-562-2525    Fax: 660-562-4303
Dr. Dallas Mullock, D.O.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2332 S Main St, Maryville, MO 64468
Phone: 660-562-2223    Fax: 660-562-2230
Dr. Brian D. Golightly, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2016 S Main St, Maryville, MO 64468
Phone: 660-562-2525    Fax: 660-562-4303
Charles S Fillingane Ii, DO
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2336 S Main St Lowr Level, Maryville, MO 64468
Phone: 660-220-2123    Fax: 660-562-7911
Bryan Robert Green, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2016 S Main St, Maryville, MO 64468
Phone: 660-562-7999    Fax: 660-562-7996
Dr. Patrick S. Dawson, M.D.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2016 S Main St, Maryville, MO 64468
Phone: 660-562-2525    Fax: 660-562-7993

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.