Alexandria Kluttz Wallace, OTD, OTR in Eglin Afb, FL - Medicare Occupational Therapist Provider

Alexandria Kluttz Wallace, OTD, OTR is a medicare enrolled "Occupational Therapist" provider in Eglin Afb, Florida. Her current practice location is 307 Boatner Rd Ste 114, Eglin Afb, Florida. You can reach out to her office (for appointments etc.) via phone at (850) 883-9314.

Alexandria Kluttz Wallace is licensed to practice in North Carolina (license number 16353) 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 1386424687.

Contact Information

	Alexandria Kluttz Wallace, OTD, OTR
	307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302
	(850) 883-9314
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Alexandria Kluttz Wallace
Gender	Female
Speciality	Occupational Therapist
Location	307 Boatner Rd Ste 114, Eglin Afb, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1386424687
Provider Enumeration Date: 10/03/2023
Last Update Date: 07/15/2025

Medicare PECOS Information:

PECOS PAC ID: 8628424678
Enrollment ID: I20231026002437

Medical Identifiers

Medical identifiers for Alexandria Kluttz Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1386424687	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	16353 (North Carolina)	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. Alexandria Kluttz Wallace allows following entities to bill medicare on her behalf.

Provider Name	Advantage Ot Inc.
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1962717025 PECOS PAC ID: 4981841582 Enrollment ID: O20130517000317

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. Alexandria Kluttz 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
Alexandria Kluttz Wallace, OTD, OTR 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 Ph: (850) 883-9314	Alexandria Kluttz Wallace, OTD, OTR 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 Ph: (850) 883-9314

Reviews and Comments

Occupational Therapist in Eglin Afb, FL

Frank Richard Pascarelli, OTR/L, BCMH, NMSE Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 96th Mdg, 307 Boatner Road, Eglin Afb, FL 32542 Phone: 404-368-4561 Fax: 404-639-2896
Mr. William Craig Soucy, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 307 Boatner Rd Ste 114, Eglin Afb, FL 32542 Phone: 850-883-8600
Mrs. Mary Elizabeth Nordgulen, OTR/L, C4T Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 307 Boatner Road, 96th Mdg, Eglin Afb, FL 32542 Phone: 850-883-8314 Fax: 334-836-2247
Debra Sjohn Secrest, OCCUPATIONAL THERAPI Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 340 Boatner Rd, Eglin Afb, FL 32542 Phone: 850-883-8313
Candice Babjak, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 307 Boatner Rd Ste 114, Eglin Afb, FL 32542 Phone: 850-883-9484
Carmel Joyner, MOT, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 307 Boatner Rd Ste 114, Eglin Afb, FL 32542 Phone: 850-883-8600

Alexandria Kluttz Wallace, OTD, OTR - Medicare Occupational Therapist in Eglin Afb, FL