DR. DANIELLE CHARISSE WALLACE M.D. - NPI 1114147006

Q: What is Danielle Wallace's NPI number?

The NPI number for Danielle Wallace is 1114147006. It was assigned to this individual provider in the NPPES registry on April 26, 2007.

Q: What is Danielle Wallace's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Danielle Wallace was last updated on June 13, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Danielle Charisse Wallace M.d. NPPES

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

DR. DANIELLE CHARISSE WALLACE M.D. (NPI 1114147006) is an individual pediatrics provider in Winter Park, Florida, licensed in Florida (ME129213) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1114147006

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. DANIELLE CHARISSE WALLACECredential: M.D.

Location Address1801 LEE RD STE 165Winter Park, FL 32789

Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560

Phone(407) 975-0410

Fax(407) 975-0413

Sole ProprietorNo

Enumeration DateApril 26, 2007

Last NPPES UpdateJune 13, 20235 updates tracked since enumeration

NPPES CertifiedJune 1, 2023

✔ NPI 1114147006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in FL · ME129213✔ Licensed in WA · MD61340360✔ Licensed in UT · 8023169-1205✔ Licensed in MI · 4301088447✔ Licensed in TX · U0741

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1801 LEE RD STE 165, Winter Park, FL 32789

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Secondary Practice Locations 2

Location 11627 S 3050 WVernal, UT 84078-8719 · Phone (616) 717-3171

Location 24845 Alameda AveEl Paso, TX 79905-2705 · Phone (915) 215-5700 · Fax (915) 215-8872

Other Identifiers 1

Medicaid2231891WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), McLaren Health Plan Community, Medica and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Danielle Charisse Wallace M.d. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32789 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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 11

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

DR. NICHOLO J. SARTOR MD

Pediatrics