MAUREEN MARY WALLACE PA-C
NPI 1073559399
Physician Assistant - Medical in Show Low, AZ

Active since June 22, 2006PECOS EnrolledAccepts Medicare Assignment
2500 E HUNT DR STE H-J, SHOW LOW, AZ 85901(928) 537-6937(928) 537-3977 Get Directions Write a Review

NPPES record last updated: June 14, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 14, 2023, Aug 26, 2020, Aug 18, 2020 (3 updates tracked since 2020).

About Maureen Mary Wallace Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAUREEN MARY WALLACE PA-C (NPI 1073559399) is an individual medical provider in Show Low, Arizona, licensed in Arizona (3191) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1073559399
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMAUREEN MARY WALLACECredential: PA-C
Location Address2500 E HUNT DR STE H-JShow Low, AZ 85901-7954
Mailing Address2500 E Hunt Dr Ste H-jShow Low, AZ 85901-7954 · (928) 537-6937 · Fax (928) 537-3977
Fax(928) 537-3977
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateJune 22, 2006
Last NPPES UpdateJune 14, 20233 updates tracked since enumeration
NPPES CertifiedJune 14, 2023
NPI 1073559399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in AZ · 3191
2500 E HUNT DR STE H-J, Show Low, AZ 85901

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Maureen Mary Wallace Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870524713
PECOS Enrollment IDI20050830000746
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
637 services263 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
59 services46 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
28 services24 patients

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
2500 E HUNT DR STE H-J
SHOW LOW, AZ 85901
Internal Medicine (Medical Oncology)
2500 E HUNT DR STE H-J
SHOW LOW, AZ 85901
Clinic/Center (Oncology)
2500 E HUNT DR STE H-J
SHOW LOW, AZ 85901
Radiology (Radiation Oncology)
2500 E HUNT DR STE H-J
SHOW LOW, AZ 85901
Internal Medicine (Hematology & Oncology)
2500 E HUNT DR STE H-J
SHOW LOW, AZ 85901

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073559399, enumerated as an "individual" on June 22, 2006.

The provider is located at 2500 E HUNT DR STE H-J SHOW LOW, AZ 85901 and the phone number is (928) 537-6937.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Blue Cross. Please consult your insurance carrier or call the provider to verify.