Dr Wallace Scott Johnson, OD is a medicare enrolled "Optometrist" provider in Pillager, Minnesota. He graduated from medical school in 1988 and has 38 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Up North Eye Care Pa and his current practice location is
775 Buckskin Ave W, Pillager, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(218) 746-2020.
Dr Wallace Scott Johnson is licensed to practice in Minnesota (license number 2196) 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 1346209020.
Healthcare Provider's Profile
| Full Name | Dr Wallace Scott Johnson |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 38 Years |
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| Location | 775 Buckskin Ave W, Pillager, Minnesota |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Wallace Scott Johnson graduated from medical school in 1988
NPI Data:
- NPI Number: 1346209020
- Provider Enumeration Date: 03/21/2006
- Last Update Date: 07/24/2025
Medicare PECOS Information:
- PECOS PAC ID: 5496871584
- Enrollment ID: I20100927000490
Medical Identifiers
Medical identifiers for Dr Wallace Scott Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1346209020 | NPI | - | NPPES |
| 63372 | Other | MN | MPIN |
| 970525200 | Medicaid | MN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152WC0802X | Optometrist - Corneal And Contact Management | 2196 (Minnesota) | Secondary |
| 152W00000X | Optometrist | 2196 (Minnesota) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Up North Eye Care Pa | 6709208887 | 2 |
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 Wallace Scott Johnson allows following entities to bill medicare on his behalf.
| Provider Name | Up North Eye Care PA |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1497389944
PECOS PAC ID: 6709208887
Enrollment ID: O20200619000565 |
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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 Wallace Scott Johnson 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 Wallace Scott Johnson, OD
775 Buckskin Ave W Ste 1,
Pillager, MN 56473-2509
Ph: (218) 746-2020 | Dr Wallace Scott Johnson, OD
775 Buckskin Ave W,
Pillager, MN 56473-2509
Ph: (218) 746-2020 |
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