Dr William Chambers Waller Jr, MD - Medicare Urology in Rapid City, SD

Dr William Chambers Waller Jr, MD is a medicare enrolled "Urology" physician in Rapid City, South Dakota. His current practice location is 2805 5th St, 220, Rapid City, South Dakota. You can reach out to his office (for appointments etc.) via phone at (605) 348-1084.

Dr William Chambers Waller Jr is licensed to practice in South Dakota (license number 4033) 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 1528069515.

Contact Information

Dr William Chambers Waller Jr, MD
2805 5th St, 220,
Rapid City, SD 57701-6003
(605) 348-1084
(605) 348-3256



Physician's Profile

Full NameDr William Chambers Waller Jr
GenderMale
SpecialityUrology
Location2805 5th St, Rapid City, South Dakota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1528069515
  • Provider Enumeration Date: 08/02/2005
  • Last Update Date: 02/27/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 6709873250
  • Enrollment ID: I20170925000281

Medical Identifiers

Medical identifiers for Dr William Chambers Waller Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1528069515NPI-NPPES
111265100MedicaidWY
460350645MedicaidNE
7500090MedicaidSD

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208800000XUrology MD60933481 (Washington)Secondary
208800000XUrology 4033 (South Dakota)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 William Chambers Waller Jr allows following entities to bill medicare on his behalf.
Entity NameBrodstone Memorial Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073590626
PECOS PAC ID: 4082513015
Enrollment ID: O20040423000949

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Entity NameChadron Community Hospital Corp.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467675629
PECOS PAC ID: 0143397034
Enrollment ID: O20140710000370

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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 William Chambers Waller Jr 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 AddressPractice Location Address
Dr William Chambers Waller Jr, MD
5171 Cub Lake Rd, Ste B280,
Show Low, AZ 85901-7888

Ph: (928) 532-8663
Dr William Chambers Waller Jr, MD
2805 5th St, 220,
Rapid City, SD 57701-6003

Ph: (605) 348-1084

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Urology Doctors in Rapid City, SD

Keith G Bryson, MD
Urology
Medicare: Not Enrolled in Medicare
Practice Location: 2805 5th St, Suite 100, Rapid City, SD 57701
Phone: 605-719-5700    Fax: 605-719-5701
Gerald W Butz, M.D.
Urology
Medicare: Not Enrolled in Medicare
Practice Location: 710 Saint Anne St, Rapid City, SD 57701
Phone: 605-348-4100    Fax: 605-348-0662
Dr. Michael James Brekhus, M.D.
Urology
Medicare: Not Enrolled in Medicare
Practice Location: 2820 Mount Rushmore Rd, Rapid City, SD 57701
Phone: 605-342-3280    
Gary Christiansen, M.D.
Urology
Medicare: Medicare Enrolled
Practice Location: 2820 Mount Rushmore Rd, Rapid City, SD 57701
Phone: 605-342-3280    Fax: 605-348-0662

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