Miata Wallace, PA - Medicare Physician Assistant in Lincoln, NE

Miata Wallace, PA is a medicare enrolled "Physician Assistant" in Lincoln, Nebraska. She graduated from nursing school in 2022 and has 2 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Bryan Physician Network, Nebraska Pulmonary Specialties Llc and her current practice location is 1500 S 58th St Ste 800, Lincoln, Nebraska. You can reach out to her office (for appointments etc.) via phone at (402) 483-8600.

Miata Wallace is licensed to practice in Nebraska (license number 2760) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1013656990.

Contact Information

Miata Wallace, PA
1500 S 58th St Ste 800,
Lincoln, NE 68506-1407
(402) 483-8600
(402) 483-8689



Provider's Profile

Full NameMiata Wallace
GenderFemale
SpecialityPhysician Assistant
Experience2 Years
Location1500 S 58th St Ste 800, Lincoln, Nebraska
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Miata Wallace graduated from nursing school in 2022
  NPI Data:
  • NPI Number: 1013656990
  • Provider Enumeration Date: 05/31/2022
  • Last Update Date: 05/31/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 1456730126
  • Enrollment ID: I20220627002051

Medical Identifiers

Medical identifiers for Miata Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1013656990NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 2760 (Nebraska)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Bryan Medical CenterLincoln, NEHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Bryan Physician Network7315915873194
Nebraska Pulmonary Specialties Llc307241288130

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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. Miata 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
Miata Wallace, PA
1500 S 58th St Ste 800,
Lincoln, NE 68506-1407

Ph: (402) 483-8600
Miata Wallace, PA
1500 S 58th St Ste 800,
Lincoln, NE 68506-1407

Ph: (402) 483-8600

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Physician Assistant Nurses in Lincoln, NE

Christina Kay Meyer, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 6969 South St, Lincoln, NE 68506
Phone: 402-413-7460    Fax: 402-413-7486
Mr. Gabriel Jefferson, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 5000 N 26th St, Suite 100, Lincoln, NE 68521
Phone: 402-435-5300    
Mrs. Sharon E Spethman, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 1500 U St, Lincoln, NE 68588
Phone: 402-472-5000    Fax: 402-472-8010
Andre N Orduna, PHYSICIAN ASSISTANT
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1500 S 48th St Ste 400, Lincoln, NE 68506
Phone: 402-481-8500    Fax: 402-483-3297
Jacklynn A Kment, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 1620 S 70th St Ste 103, Lincoln, NE 68506
Phone: 402-318-3550    Fax: 402-318-3546
Mrs. Catherine M Bateman, PA
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 4545 R St, Suite 100, Lincoln, NE 68503
Phone: 402-465-4545    Fax: 402-465-9011
Michael Krage Kowalke, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 6900 A St, Ste 100, Lincoln, NE 68510
Phone: 402-436-2000    

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