Eric Wallace, PHD in Shaker Heights, OH - Medicare Psychologist Provider

Eric Wallace, PHD is a medicare enrolled "Psychologist - Counseling" provider in Shaker Heights, Ohio. His current practice location is 22001 Fairmount Blvd, Shaker Heights, Ohio. You can reach out to his office (for appointments etc.) via phone at (216) 320-8456.

Eric Wallace is licensed to practice in Ohio (license number P.07864) 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 1912409160.

Contact Information

	Eric Wallace, PHD
	22001 Fairmount Blvd, Shaker Heights, OH 44118-4819
	(216) 320-8456
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Eric Wallace
Gender	Male
Speciality	Psychologist - Counseling
Location	22001 Fairmount Blvd, Shaker Heights, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1912409160
Provider Enumeration Date: 03/05/2018
Last Update Date: 03/20/2019

Medicare PECOS Information:

PECOS PAC ID: 1052732260
Enrollment ID: I20200526001569

Medical Identifiers

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

Identifier	Type	State	Issuer
1912409160	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC1900X	Psychologist - Counseling	P.07864 (Ohio)	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. Eric Wallace allows following entities to bill medicare on his behalf.

Entity Name	State Of Ohio Office Of Budget And Management State Accounting
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023082716 PECOS PAC ID: 0143133181 Enrollment ID: O20031202000209

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. Eric 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
Eric Wallace, PHD 22001 Fairmount Blvd, Shaker Heights, OH 44118-4819 Ph: (216) 320-8456	Eric Wallace, PHD 22001 Fairmount Blvd, Shaker Heights, OH 44118-4819 Ph: (216) 320-8456

Reviews and Comments

Psychologist in Shaker Heights, OH

Dr. Laura Michelle Fogarty, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3294 Van Aken Blvd, Shaker Heights, OH 44120 Phone: 216-647-9382
Dr. Stacy Feiner, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 22001 Fairmount Blvd, Shaker Heights, OH 44118 Phone: 216-320-8222
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Jennifer Franklin, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 20310 Chagrin Blvd, Ste 2, Shaker Heights, OH 44122 Phone: 216-491-9405 Fax: 216-491-8025
Dr. William Andrew Schutt, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 19910 Malvern Rd, Shaker Heights, OH 44122 Phone: 216-544-1321
Kelly Levandowski, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3638 Townley Rd, Shaker Heights, OH 44122 Phone: 216-832-2467
Mrs. Rasheeda Smialek, SCHOOL PSYCHOLOGIST Psychologist Medicare: Not Enrolled in Medicare Practice Location: 16824 Holbrook Rd, Shaker Heights, OH 44120 Phone: 216-408-6672

Eric Wallace, PHD - Medicare Psychologist in Shaker Heights, OH