Mary Wallace, OTR in Saint Charles, MO - Medicare Occupational Therapist Provider

Mary Wallace, OTR is a medicare enrolled "Occupational Therapist" provider in Saint Charles, Missouri. Her current practice location is 2150 W Randolph St, Saint Charles, Missouri. You can reach out to her office (for appointments etc.) via phone at (636) 946-4966.

Mary Wallace is licensed to practice in Missouri (license number 2022037104) 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 1689398141.

Contact Information

	Mary Wallace, OTR
	2150 W Randolph St, Saint Charles, MO 63301-0844
	(636) 946-4966
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mary Wallace
Gender	Female
Speciality	Occupational Therapist
Location	2150 W Randolph St, Saint Charles, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1689398141
Provider Enumeration Date: 09/28/2022
Last Update Date: 04/14/2023

Medicare PECOS Information:

PECOS PAC ID: 6709262140
Enrollment ID: I20221007001740

Medical Identifiers

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

Identifier	Type	State	Issuer
1689398141	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	2022037104 (Missouri)	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. Mary Wallace allows following entities to bill medicare on her behalf.

Provider Name	Legacy Healthcare Services Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1407487366 PECOS PAC ID: 2163339722 Enrollment ID: O20200327001604

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. Mary 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
Mary Wallace, OTR 7527 Teasdale Ave, Saint Louis, MO 63130-3923 Ph: () -	Mary Wallace, OTR 2150 W Randolph St, Saint Charles, MO 63301-0844 Ph: (636) 946-4966

Reviews and Comments

Occupational Therapist in Saint Charles, MO

Mckenzie Lynn Murphy, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 400 1st Capitol Dr Ste 101, Saint Charles, MO 63301 Phone: 636-947-5467
Leica Marie Haire, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 7001 S Highway 94, Saint Charles, MO 63304 Phone: 636-851-4700
Amy Etter, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 3330 Ehlmann Rd, Saint Charles, MO 63301 Phone: 877-407-3422 Fax: 877-407-4329
Taylor M Macker, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1468 Norwood Dr, Saint Charles, MO 63303 Phone: 636-866-1341
Morgan Williams, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3330 Ehlmann Rd, Saint Charles, MO 63301 Phone: 877-407-3422 Fax: 877-407-4329
Mckenzie Laine Struckhoff, MOT, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1552 Country Club Plaza Dr Unit 1570, Saint Charles, MO 63303 Phone: 636-724-1127
Joan Risik, Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 3330 Ehlmann Rd, Saint Charles, MO 63301 Phone: 877-407-3422 Fax: 877-407-4329

Mary Wallace, OTR - Medicare Occupational Therapist in Saint Charles, MO