Shane K Wallace, CRNA in Pikeville, KY - Medicare Certified Registered Nurse Anesthetist (crna)

Shane K Wallace, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Pikeville, Kentucky. He graduated from nursing school in 2008 and has 17 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Medstream Anesthesia Pllc, Pikeville Medical Center Inc and his current practice location is 911 Bypass Rd Bldg A, Pikeville, Kentucky. You can reach out to his office (for appointments etc.) via phone at (606) 430-3500.

Shane K Wallace is licensed to practice in Kentucky (license number 3008218) 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 1235378605.

Contact Information

	Shane K Wallace, CRNA
	911 Bypass Rd Bldg A, Pikeville, KY 41501-1689
	(606) 430-3500
	(606) 437-1033

Map and Direction

Provider's Profile

Full Name	Shane K Wallace
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	17 Years
Location	911 Bypass Rd Bldg A, Pikeville, Kentucky
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:

Shane K Wallace graduated from nursing school in 2008

NPI Data:

NPI Number: 1235378605
Provider Enumeration Date: 02/09/2009
Last Update Date: 08/02/2023

Medicare PECOS Information:

PECOS PAC ID: 2668520750
Enrollment ID: I20090429000349

Medical Identifiers

Medical identifiers for Shane K Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1235378605	NPI	-	NPPES
1235378605	Medicaid	VA
7100075570	Medicaid	KY

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	0001179608 (Virginia)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	0024168171 (Virginia)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	33501 (Tennessee)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	3008218 (Kentucky)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Pikeville Medical Center	Pikeville, KY	Hospital
Clinch Valley Medical Center	Richlands, VA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Medstream Anesthesia Pllc	7416198049	515
Pikeville Medical Center Inc	6709790157	384

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. Shane K Wallace allows following entities to bill medicare on his behalf.

Entity Name	Medstream Anesthesia Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649616160 PECOS PAC ID: 7416198049 Enrollment ID: O20130724000770

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. Shane K 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
Shane K Wallace, CRNA Po Box 432, Pikeville, KY 41502-0432 Ph: (606) 430-3500	Shane K Wallace, CRNA 911 Bypass Rd Bldg A, Pikeville, KY 41501-1689 Ph: (606) 430-3500

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Pikeville, KY

Trulena Benner, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 911 Bypass Rd Bldg A, Pikeville, KY 41501 Phone: 606-430-3500 Fax: 606-437-1033
Sandra Perry, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 911 Bypass Rd, Pikeville, KY 41501 Phone: 606-218-3500
Mr. Jamie Martin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 911 Bypass Rd Bldg A, Pikeville, KY 41501 Phone: 606-430-3500 Fax: 606-437-1033
Jamie Aker, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 911 Bypass Rd Bldg A, Pikeville, KY 41501 Phone: 606-430-3500 Fax: 606-437-1033
Kent Clifford Ficklin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 911 Bypass Rd Bldg A, Pikeville, KY 41501 Phone: 606-430-3500 Fax: 606-437-1033
Hannah N Province, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 911 Bypass Rd, Pikeville, KY 41501 Phone: 606-218-3500
Eric L Herrell, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 911 Bypass Rd, Pikeville, KY 41501 Phone: 606-218-3500

Shane K Wallace, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Pikeville, KY