Mr Aaron Michael Wallace, MD - Medicare Pediatrics in Portland, ME

Mr Aaron Michael Wallace, MD is a medicare enrolled "Pediatrics" physician in Portland, Maine. His current practice location is 22 Bramhall St, Portland, Maine. You can reach out to his office (for appointments etc.) via phone at (207) 662-2911.

Mr Aaron Michael Wallace is licensed to practice in Maine (license number MD23914) 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 1073037016.

Contact Information

Mr Aaron Michael Wallace, MD
22 Bramhall St,
Portland, ME 04102-3134
(207) 662-2911
Not Available



Physician's Profile

Full NameMr Aaron Michael Wallace
GenderMale
SpecialityPediatrics
Location22 Bramhall St, Portland, Maine
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1073037016
  • Provider Enumeration Date: 08/01/2017
  • Last Update Date: 06/12/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 0648694059
  • Enrollment ID: I20230830002417

Medical Identifiers

Medical identifiers for Mr Aaron Michael Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073037016NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics MD23914 (Maine)Primary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Secondary

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. Mr Aaron Michael Wallace allows following entities to bill medicare on his behalf.
Entity NameMaine Medical Partners
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467477349
PECOS PAC ID: 9335043967
Enrollment ID: O20031125000026

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Entity NameMaine Medical Partners
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134144090
PECOS PAC ID: 9335043967
Enrollment ID: O20040331000191

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Entity NameMainehealth
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1790265502
PECOS PAC ID: 7517860588
Enrollment ID: O20040701000166

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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. Mr Aaron Michael 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 AddressPractice Location Address
Mr Aaron Michael Wallace, MD
17 Wingate Dr,
Portland, ME 04102-1829

Ph: (860) 214-6273
Mr Aaron Michael Wallace, MD
22 Bramhall St,
Portland, ME 04102-3134

Ph: (207) 662-2911

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Pediatrics Doctors in Portland, ME

Dr. Thomas Mellow, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 887 Congress St, Suite 320, Portland, ME 04102
Phone: 207-662-5522    Fax: 207-662-5527
Rushika M Conroy, M.D.
Pediatrics
Medicare: Accepting Medicare Assignments
Practice Location: 41 Donald B Dean Dr Ste A, Portland, ME 04106
Phone: 207-661-6064    
Michael Alexander Ferguson, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 22 Bramhall St, Mmc Picu, Portland, ME 04102
Phone: 207-662-6711    
Dr. Rute S Rothwell, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 22 Bramhall St, Portland, ME 04102
Phone: 207-662-7060    
Kenneth Lombard, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 887 Congress St, Suite 410b, Portland, ME 04102
Phone: 207-662-5522    Fax: 207-662-5526
David F Cox, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 22 Bramhall St, Portland, ME 04102
Phone: 207-662-2353    
Marie H Tanzer, MD
Pediatrics
Medicare: Accepting Medicare Assignments
Practice Location: 887 Congress St, Suite 320, Portland, ME 04102
Phone: 207-662-5522    Fax: 207-662-5527

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