Tracey C Wallace, MD - Medicare Family Practice in Atlanta, GA

Tracey C Wallace, MD is a medicare enrolled "Family Medicine" physician in Atlanta, Georgia. He went to Loma Linda University School Of Medicine and graduated in 1993 and has 31 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Northside Urgent Care Holding Llc and his current practice location is 3525 Piedmont Rd Ne, Bldg 7-601, Atlanta, Georgia. You can reach out to his office (for appointments etc.) via phone at (770) 509-1025.

Tracey C Wallace is licensed to practice in Georgia (license number 042483) 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 1265475206.

Contact Information

Tracey C Wallace, MD
3525 Piedmont Rd Ne, Bldg 7-601,
Atlanta, GA 30305-1578
(770) 509-1025
Not Available



Physician's Profile

Full NameTracey C Wallace
GenderMale
SpecialityFamily Practice
Experience31 Years
Location3525 Piedmont Rd Ne, Atlanta, Georgia
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Tracey C Wallace attended and graduated from Loma Linda University School Of Medicine in 1993
  NPI Data:
  • NPI Number: 1265475206
  • Provider Enumeration Date: 06/14/2006
  • Last Update Date: 02/26/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 2769383892
  • Enrollment ID: I20111026000845

Medical Identifiers

Medical identifiers for Tracey C Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1265475206NPI-NPPES
00777697AMedicaidGA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 042483 (Georgia)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Northside HospitalAtlanta, GAHospital
Wellstar Kennestone HospitalMarietta, GAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Northside Urgent Care Holding Llc458798469561

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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. Tracey C Wallace allows following entities to bill medicare on his behalf.
Entity NameNorthside Primary Care Professional Services,llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922397553
PECOS PAC ID: 9638343924
Enrollment ID: O20111123000206

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Entity NameNorthside Urgent Care Holding Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1679962237
PECOS PAC ID: 4587984695
Enrollment ID: O20150513000795

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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. Tracey C 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
Tracey C Wallace, MD
1121 Johnson Ferry Rd, Suite 100,
Marietta, GA 30068-5425

Ph: (770) 509-1025
Tracey C Wallace, MD
3525 Piedmont Rd Ne, Bldg 7-601,
Atlanta, GA 30305-1578

Ph: (770) 509-1025

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Family Medicine Doctors in Atlanta, GA

Fidelia O Osinubi, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 3885 Princeton Lakes Way, Suite 402, Atlanta, GA 30331
Phone: 404-349-0496    Fax: 404-349-6081
Theresa R Jacobs, MD
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 868 York Ave Sw, Atlanta, GA 30310
Phone: 404-752-1400    Fax: 404-758-0740
David M Williams, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1046 Ridge Ave Sw, Atlanta, GA 30315
Phone: 404-688-1350    Fax: 404-564-6734
Tony Serrano-padin, M.D.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 1701 Hardee Ave. Sw, Bldg 125, Fort Mcpherson - Army Health Clinic, Atlanta, GA 30330
Phone: 404-464-0389    
Dr. Bhavi Patel Purohit, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 720 Westview Dr Sw, Atlanta, GA 30310
Phone: 404-756-1230    Fax: 404-752-8682
Dr. Edmond Shih, M.D.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 5461 Buford Hwy Ne, Atlanta, GA 30340
Phone: 770-457-5556    Fax: 770-457-7776
Zahidul Islam Chowdhury, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 240 N Highland Ave Ne, Suite F, Atlanta, GA 30307
Phone: 404-658-9840    Fax: 404-658-9846

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