Allen Wallace, CRNA - Medicare Nurse Anesthetist, Certified Registered in Roosevelt, UT

  1. Home
  2. Nurse Anesthetist - CR
  3. UT
  4. Roosevelt
Allen Wallace, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Roosevelt, Utah. His current practice location is 250 W 300 N, Roosevelt, Utah. You can reach out to his office (for appointments etc.) via phone at (435) 722-6163.

Allen Wallace is licensed to practice in Utah (license number 192839-4406) 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 1295798163.

Contact Information

Allen Wallace, CRNA
250 W 300 N,
Roosevelt, UT 84066-2336
(435) 722-6163
(435) 722-9291

Map and Direction




Provider's Profile

Full NameAllen Wallace
GenderMale
SpecialityNurse Anesthetist, Certified Registered
Location250 W 300 N, Roosevelt, Utah
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1295798163
  • Provider Enumeration Date: 04/10/2006
  • Last Update Date: 11/30/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 8022072164
  • Enrollment ID: I20041117001044

Medical Identifiers

Medical identifiers for Allen Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1295798163NPI-NPPES
D0808MedicaidUT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 192839-4406 (Utah)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. Allen Wallace allows following entities to bill medicare on his behalf.
Entity NameUintah Basin Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871556217
PECOS PAC ID: 0244131944
Enrollment ID: O20040226000948
Entity NameUbmc Anesthesiology
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043643877
PECOS PAC ID: 4981833381
Enrollment ID: O20140205001393

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. Allen 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
Allen Wallace, CRNA
250 W 300 N,
Roosevelt, UT 84066-2336

Ph: (435) 722-6163		Allen Wallace, CRNA
250 W 300 N,
Roosevelt, UT 84066-2336

Ph: (435) 722-6163

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Roosevelt, UT

Lucas C Reichert, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1126 W Grayhawk Loop, Roosevelt, UT 84066
Phone: 207-659-8756    
Trent Bell, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 250 W 300 N, Roosevelt, UT 84066
Phone: 435-722-6163    Fax: 435-722-9291
Frank Guercio, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 250 W 300 N, Roosevelt, UT 84066
Phone: 435-722-6163    Fax: 435-722-9291
Steven R Knight, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 250 W 300 N, Roosevelt, UT 84066
Phone: 435-722-6163    Fax: 435-722-9291

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.