Adam Waller, NP in West Frankfort, IL - Medicare Nurse Practitioner

Adam Waller, NP is a medicare enrolled "Nurse Practitioner" in West Frankfort, Illinois. He graduated from nursing school in 2020 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Southern Illinois Medical Services Nfp, Logan Primary Care Service Corp. and his current practice location is 502 W Saint Louis St Ste 4, West Frankfort, Illinois. You can reach out to his office (for appointments etc.) via phone at (618) 937-3400.

Adam Waller is licensed to practice in Illinois (license number 209021745) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1508476615.

Contact Information

	Adam Waller, NP
	502 W Saint Louis St Ste 4, West Frankfort, IL 62896-1968
	(618) 937-3400
	(618) 997-9324

Map and Direction

Provider's Profile

Full Name	Adam Waller
Gender	Male
Speciality	Nurse Practitioner
Experience	5 Years
Location	502 W Saint Louis St Ste 4, West Frankfort, Illinois
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Adam Waller graduated from nursing school in 2020

NPI Data:

NPI Number: 1508476615
Provider Enumeration Date: 08/04/2020
Last Update Date: 05/23/2022

Medicare PECOS Information:

PECOS PAC ID: 9931527512
Enrollment ID: I20200914002215

Medical Identifiers

Medical identifiers for Adam Waller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1508476615	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	209021745 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Hospice Of Southern Ill, Inc	Belleville, IL	Hospice
Southern Illinois Hospital Services Dba Herrin Hospital	Herrin, IL	Hospital
Memorial Hospital Of Carbondale	Carbondale, IL	Hospital
Franklin Hospital	Benton, IL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Southern Illinois Medical Services Nfp	3678677390	299
Logan Primary Care Service Corp.	8628967064	34

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. Adam Waller allows following entities to bill medicare on his behalf.

Entity Name	Southern Illinois Medical Services Nfp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595

Entity Name	Signify Health Medical Associates Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20190507001451

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. Adam Waller 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
Adam Waller, NP Po Box 3988, Carbondale, IL 62902-3988 Ph: (618) 937-3400	Adam Waller, NP 502 W Saint Louis St Ste 4, West Frankfort, IL 62896-1968 Ph: (618) 937-3400

Reviews and Comments

Nurse Practitioner Nurses in West Frankfort, IL

Travis Michael Seddon, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 502 W Saint Louis St Ste 4, West Frankfort, IL 62896 Phone: 618-937-3400 Fax: 618-932-9010
Janalyn Elwood, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 502 W Saint Louis St Ste 4, West Frankfort, IL 62896 Phone: 618-937-3400 Fax: 618-932-9010
Kendra Megan Fischer, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 309 W Saint Louis St, West Frankfort, IL 62896 Phone: 618-932-8375 Fax: 618-932-8575
Moya Racquel Cook, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 502 W St Louis St, West Frankfort, IL 62896 Phone: 618-937-3400 Fax: 618-937-3407
Mrs. Krysten Taylor Whitehead, APRN FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 909 W Main St, West Frankfort, IL 62896 Phone: 618-372-6040
Max A Baier, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2553 Ken Gray Blvd, West Frankfort, IL 62896 Phone: 618-932-3937 Fax: 618-932-2734

Adam Waller, NP - Medicare Nurse Practitioner in West Frankfort, IL