Mark Waller, PT in Lehigh Acres, FL - Medicare Physical Therapist Provider

Mark Waller, PT is a medicare enrolled "Physical Therapist" provider in Lehigh Acres, Florida. His current practice location is 11742 Eros Rd, Lehigh Acres, Florida. You can reach out to his office (for appointments etc.) via phone at (239) 671-8962.

Mark Waller is licensed to practice in Florida (license number 16250) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1801525381.

Contact Information

	Mark Waller, PT
	11742 Eros Rd, Lehigh Acres, FL 33971-3759
	(239) 671-8962
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mark Waller
Gender	Male
Speciality	Physical Therapist
Location	11742 Eros Rd, Lehigh Acres, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1801525381
Provider Enumeration Date: 06/09/2022
Last Update Date: 06/09/2022

Medicare PECOS Information:

PECOS PAC ID: 9032582689
Enrollment ID: I20230301000540

Medical Identifiers

Medical identifiers for Mark Waller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1801525381	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	16250 (Florida)	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. Mark Waller allows following entities to bill medicare on his behalf.

Provider Name	Legacy Healthcare Services Inc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1336535988 PECOS PAC ID: 2163339722 Enrollment ID: O20150805009289

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. Mark Waller 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
Mark Waller, PT 11742 Eros Rd, Lehigh Acres, FL 33971-3759 Ph: (239) 671-8962	Mark Waller, PT 11742 Eros Rd, Lehigh Acres, FL 33971-3759 Ph: (239) 671-8962

Reviews and Comments

Physical Therapist in Lehigh Acres, FL

Margarita Harris, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4316 Lee Blvd, 12a & 12b, Lehigh Acres, FL 33971 Phone: 239-368-7744 Fax: 239-368-7824
Bopinder Singh, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1150 Lee Blvd Ste 3, Lehigh Acres, FL 33936 Phone: 239-369-3799
Marisa Hastings, Physical Therapist Medicare: Medicare Enrolled Practice Location: 4316 Lee Blvd Unit 12b, Lehigh Acres, FL 33971 Phone: 239-368-7744
Peter Armetta, Physical Therapist Medicare: Medicare Enrolled Practice Location: 4316 Lee Blvd Unit 12b, Lehigh Acres, FL 33971 Phone: 239-368-7744 Fax: 239-368-7824
Mrs. Emily Ann Kupper, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2724 5th St W Ste A, Lehigh Acres, FL 33971 Phone: 239-303-1501 Fax: 888-803-9101
Katherine Anne Sellaroli, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4316 Lee Blvd Unit 12b, Lehigh Acres, FL 33971 Phone: 239-368-7744
Annie Elizabeth Willsey, Physical Therapist Medicare: Medicare Enrolled Practice Location: 4316 Lee Blvd Unit 12b, Lehigh Acres, FL 33971 Phone: 239-368-7744

Mark Waller, PT - Medicare Physical Therapist in Lehigh Acres, FL