Kelsey A Wallace, CRNA in Springfield, IL - Medicare Certified Registered Nurse Anesthetist (crna)

Kelsey A Wallace, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Springfield, Illinois. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Memorial Medical Center and her current practice location is 701 N 1st St, Springfield, Illinois. You can reach out to her office (for appointments etc.) via phone at (217) 788-3000.

Kelsey A Wallace is licensed to practice in Illinois (license number 209019523) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1013576990.

Contact Information

	Kelsey A Wallace, CRNA
	701 N 1st St, Springfield, IL 62781-0001
	(217) 788-3000
	Not Available

Map and Direction

Provider's Profile

Full Name	Kelsey A Wallace
Gender	Female
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	5 Years
Location	701 N 1st St, Springfield, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kelsey A Wallace graduated from nursing school in 2019

NPI Data:

NPI Number: 1013576990
Provider Enumeration Date: 06/13/2019
Last Update Date: 06/17/2019

Medicare PECOS Information:

PECOS PAC ID: 6709111321
Enrollment ID: I20190718000338

Medical Identifiers

Medical identifiers for Kelsey A Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013576990	NPI	-	NPPES
041-420825	Other	IL	RN LICENSE
209019523	Other	IL	CRNA LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	209019523 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Memorial Medical Center	Springfield, IL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Memorial Medical Center	7315835949	115

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. Kelsey A Wallace allows following entities to bill medicare on her behalf.

Entity Name	Memorial Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255393112 PECOS PAC ID: 7315835949 Enrollment ID: O20040713000579

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. Kelsey A 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
Kelsey A Wallace, CRNA Po Box 3428, Springfield, IL 62708-3428 Ph: (217) 588-2624	Kelsey A Wallace, CRNA 701 N 1st St, Springfield, IL 62781-0001 Ph: (217) 788-3000

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Springfield, IL

Douglas Mcdonald Childs, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 800 E Carpenter St, Springfield, IL 62704 Phone: 217-525-5643 Fax: 217-544-2521
Carol A Gorden, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St, Springfield, IL 62781 Phone: 217-788-3754 Fax: 217-788-7071
Ann R Larson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St, Anesthesia Department, Springfield, IL 62781 Phone: 217-788-3754 Fax: 217-788-7071
Jenna Younker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Carpenter St, Springfield, IL 62702 Phone: 217-525-5643 Fax: 217-544-2521
Delores A Gallo, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1025 S 6th St, Springfield, IL 62703 Phone: 217-528-7541
Larry D. Sartore, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 800 East Carpenter Street, Room 2k64, Springfield, IL 62769 Phone: 217-525-5643 Fax: 217-544-3311

Kelsey A Wallace, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Springfield, IL