Ms Jessica Dene Wallace, CNM in Tuba City, AZ - Medicare Advanced Practice Midwife

Ms Jessica Dene Wallace, CNM is a medicare enrolled "Advanced Practice Midwife" in Tuba City, Arizona. Her current practice location is 167 North Main Street, Tuba City, Arizona. You can reach out to her office (for appointments etc.) via phone at (928) 283-2501.

Ms Jessica Dene Wallace is licensed to practice in Arizona (license number CNM278747) 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 1760100028.

Contact Information

	Ms Jessica Dene Wallace, CNM
	167 North Main Street, Tuba City, AZ 86045-0600
	(928) 283-2501
	(928) 283-2677

Map and Direction

Provider's Profile

Full Name	Ms Jessica Dene Wallace
Gender	Female
Speciality	Advanced Practice Midwife
Location	167 North Main Street, Tuba City, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1760100028
Provider Enumeration Date: 08/22/2022
Last Update Date: 08/22/2022

Medicare PECOS Information:

PECOS PAC ID: 4688059181
Enrollment ID: I20220920001816

Medical Identifiers

Medical identifiers for Ms Jessica Dene Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1760100028	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367A00000X	Advanced Practice Midwife	CNM278747 (Arizona)	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. Ms Jessica Dene Wallace allows following entities to bill medicare on her behalf.

Entity Name	Tuba City Regional Health Care Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548294424 PECOS PAC ID: 4284542531 Enrollment ID: O20031105000107

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. Ms Jessica Dene 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
Ms Jessica Dene Wallace, CNM Po Box 600, Tuba City, AZ 86045-0600 Ph: (928) 283-2781	Ms Jessica Dene Wallace, CNM 167 North Main Street, Tuba City, AZ 86045-0600 Ph: (928) 283-2501

Reviews and Comments

Advanced Practice Midwife Nurses in Tuba City, AZ

Nikki Skrinak, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 167 North Main Street, Tuba City, AZ 86045 Phone: 928-283-2501 Fax: 928-283-2677
Nancy S Whitson, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 167 North Main Street, Tuba City, AZ 86045 Phone: 928-283-2501 Fax: 928-283-2677
Heidi Young-blackgoat, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 167 Main St, Tuba City, AZ 86045 Phone: 866-976-5941
Linda Higgins, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 167 N Main Street, Tuba City, AZ 86045 Phone: 928-283-2441

Ms Jessica Dene Wallace, CNM - Medicare Advanced Practice Midwife in Tuba City, AZ