Dr Ken Carlson Walls, PHD, MPAS, DO is a medicare enrolled "Internal Medicine" in Riverside, California. He went to Lake Erie College Of Osteopathic Medicine, Erie and graduated in 2020 and has 6 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice County Of Riverside and his current practice location is
10800 Magnolia Ave, Riverside, California. You can reach out to his office (for appointments etc.) via phone at
(951) 353-2000.
Dr Ken Carlson Walls is licensed to practice in California (license number PTL1723) 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 1992162242.
Provider's Profile
| Full Name | Dr Ken Carlson Walls |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 6 Years |
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| Location | 10800 Magnolia Ave, Riverside, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Ken Carlson Walls attended and graduated from Lake Erie College Of Osteopathic Medicine, Erie in 2020
NPI Data:
- NPI Number: 1992162242
- Provider Enumeration Date: 01/18/2016
- Last Update Date: 09/26/2023
Medicare PECOS Information:
- PECOS PAC ID: 9032490149
- Enrollment ID: I20230316002859
Medical Identifiers
Medical identifiers for Dr Ken Carlson Walls such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1992162242 | NPI | - | NPPES |
| 1992162242 | Medicaid | TX | |
| 1992162242 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | PTL1723 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| County Of Riverside | 6507754488 | 188 |
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. Dr Ken Carlson Walls allows following entities to bill medicare on his behalf.
| Entity Name | County Of Riverside |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1023122967
PECOS PAC ID: 6507754488
Enrollment ID: O20040310001107 |
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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. Dr Ken Carlson Walls 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 |
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Dr Ken Carlson Walls, PHD, MPAS, DO
12143 Dewar Dr,
Riverside, CA 92505-4106
Ph: (314) 488-5943 | Dr Ken Carlson Walls, PHD, MPAS, DO
10800 Magnolia Ave,
Riverside, CA 92505-3043
Ph: (951) 353-2000 |
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