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MRS. AMY M WALLACE APRN, NNP-BC
NPI 1104178052
Nurse Practitioner - Neonatal in Lexington, KY

Active since October 02, 2012PECOS Enrolled
800 ROSE ST FL 4, LEXINGTON, KY 40536(859) 218-2581(859) 257-1632 Get Directions Write a Review

NPPES record last updated: June 6, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Amy M Wallace Aprn, Nnp-bc NPPES

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

MRS. AMY M WALLACE APRN, NNP-BC (NPI 1104178052) is an individual neonatal provider in Lexington, Kentucky, licensed in Kentucky (3007721) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104178052
Entity TypeIndividualFemale
Primary Taxonomy363LN0000X
Provider Legal NameMRS. AMY M WALLACECredential: APRN, NNP-BC
Location Address800 ROSE ST FL 4Lexington, KY 40536-0001
Mailing Address800 Rose St, 4th FloorLexington, KY 40536-0001 · (859) 323-0101
Phone(859) 218-2581
Fax(859) 257-1632
Sole ProprietorNo
Enumeration DateOctober 2, 2012
Last NPPES UpdateJune 6, 2024
NPPES CertifiedJune 6, 2024
✔ NPI 1104178052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · NeonatalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LN0000X
License✔ Licensed in KY · 3007721
Also ListedNurse Practitioner · Neonatal, Critical CareTaxonomy 363LN0005X · License 3007721 (KY)
800 ROSE ST FL 4, Lexington, KY 40536
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Amy M Wallace Aprn, Nnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Amy Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Saint Joseph Health System, Inc
66 mi
Rural Health
298 BOGLE ST STE A
Somerset, KY 42503
  • Reassigned Medicare billing, Kentucky enrollment
  • 46 clinicians in this Medicare group
NPI 1609543651 (606) 679-9213

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40536 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

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

VINCENT GOUGE MD
Pediatrics
800 ROSE ST FL 4
LEXINGTON, KY 40536
Fayette County (859) 218-2581
KELSEY WAGLER
Nurse Practitioner (Acute Care)
800 ROSE ST FL 4
LEXINGTON, KY 40536
Fayette County (859) 257-4554
RANJIT PRAKASH TORGALKAR MD
Pediatrics (Neonatal-Perinatal Medicine)
800 ROSE ST FL 4
LEXINGTON, KY 40536
Fayette County (859) 562-1085
HANNAH MCATEE MD
Pediatrics (Hospice and Palliative Medicine)
800 ROSE ST FL 4
LEXINGTON, KY 40536
Fayette County (859) 218-2581
FAIZA HASSAN MD
Pediatrics
800 ROSE ST FL 4
LEXINGTON, KY 40536
Fayette County (859) 218-2581
JOHNNA FORMAN APRN
Nurse Practitioner (Acute Care)
800 ROSE ST FL 4
LEXINGTON, KY 40536
Fayette County (859) 218-2581
DR. KASHIF SHAKEEL DIN MD
Student in an Organized Health Care Education/Training Program
800 ROSE ST FL 4
LEXINGTON, KY 40536
Fayette County (859) 323-5000
JULIE TOKATLIAN DDS
Dentist (Periodontics)
800 ROSE ST FL 4
LEXINGTON, KY 40536
Fayette County (859) 323-6193

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amy Wallace's NPI number?

The NPI number for Amy Wallace is 1104178052. It was assigned to this individual provider in the NPPES registry on October 2, 2012.

Where is Amy Wallace located?

Amy Wallace practices at 800 Rose St Fl 4, Lexington, KY 40536. The listed phone number is (859) 218-2581.

What is Amy Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, with taxonomy code 363LN0000X.

Is Amy Wallace enrolled in Medicare?

Yes. Amy Wallace is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Amy Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amy Wallace reassigns Medicare benefits to Saint Joseph Health System, Inc (Somerset, KY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Amy Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amy Wallace accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter of Tennessee list Amy Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Amy Wallace was last updated on June 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.