Dr Jamila Shani Wallace, OD in South Pasadena, CA

Dr Jamila Shani Wallace, OD is a medicare enrolled "Optometrist" provider in South Pasadena, California. Her current practice location is 1103 Fair Oaks Ave, South Pasadena, California. You can reach out to her office (for appointments etc.) via phone at (626) 441-0770.

Dr Jamila Shani Wallace is licensed to practice in California (license number 34793) 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 1033798079.

Contact Information

	Dr Jamila Shani Wallace, OD
	1103 Fair Oaks Ave, South Pasadena, CA 91030-3311
	(626) 441-0770
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Jamila Shani Wallace
Gender	Female
Speciality	Optometrist
Location	1103 Fair Oaks Ave, South Pasadena, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033798079
Provider Enumeration Date: 04/06/2021
Last Update Date: 04/06/2021

Medicare PECOS Information:

PECOS PAC ID: 9133538168
Enrollment ID: I20210504001488

Medical Identifiers

Medical identifiers for Dr Jamila Shani Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033798079	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	34793 (California)	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. Dr Jamila Shani Wallace allows following entities to bill medicare on her behalf.

Provider Name	Justin Hu, O.d., Incorporated
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1508148941 PECOS PAC ID: 7214108968 Enrollment ID: O20110929000132

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. Dr Jamila Shani 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
Dr Jamila Shani Wallace, OD 1103 Fair Oaks Ave, South Pasadena, CA 91030-3311 Ph: () -	Dr Jamila Shani Wallace, OD 1103 Fair Oaks Ave, South Pasadena, CA 91030-3311 Ph: (626) 441-0770

Reviews and Comments

Optometrist in South Pasadena, CA

Dr. Irene Nora Sang, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 729 Mission St Ste 200, South Pasadena, CA 91030 Phone: 626-441-5300 Fax: 626-441-2880
Frederick R. Harris, O.d., Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1941 Huntington Dr, Suite F, South Pasadena, CA 91030 Phone: 626-799-2212
Dr. Jaime Chan, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 1024 Mission St Ste B, South Pasadena, CA 91030 Phone: 626-460-6022
Dr. Shelly Holcomb Lowe, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 729 Mission St Ste 200, South Pasadena, CA 91030 Phone: 626-441-5300 Fax: 626-441-2880
Dr. Hripsime Shirvanian, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 1024 Mission St, Suite B, South Pasadena, CA 91030 Phone: 626-460-6022 Fax: 626-460-6024
Christina Liu, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 729 Mission St Ste 200, South Pasadena, CA 91030 Phone: 626-441-5300

Dr Jamila Shani Wallace, OD - Medicare Optometrist in South Pasadena, CA