DR. DANIELLE CHARISSE WALLACE M.D.
NPI 1114147006
Pediatrics in Winter Park, FL
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
Specialties & Licenses
Secondary Practice Locations 2
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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).
Medicare Billing Reassignments
9Medicare enrollment records show Danielle Wallace reassigns Medicare billing to 9 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Orlando, FL 32803
- Reassigned Medicare billing, Florida enrollment
- 3,005 clinicians in this Medicare group
Cudjoe Key, FL 33042
- Reassigned Medicare billing, Florida enrollment
- 71 clinicians in this Medicare group
Ithaca, MI 48847
- Reassigned Medicare billing, Michigan enrollment
- 258 clinicians in this Medicare group
Bad Axe, MI 48413
- Reassigned Medicare billing, Michigan enrollment
- 62 clinicians in this Medicare group
Gladwin, MI 48624
- Reassigned Medicare billing, Michigan enrollment
- 162 clinicians in this Medicare group
Alpena, MI 49707
- Reassigned Medicare billing, Michigan enrollment
- 219 clinicians in this Medicare group
Carlsbad, NM 88220
- Reassigned Medicare billing, New Mexico enrollment
- 71 clinicians in this Medicare group
El Paso, TX 79927
- Reassigned Medicare billing, Texas enrollment
- Medicare enrollment name: Texas Tech University Health Sciences Center El Paso
- 856 clinicians in this Medicare group
Moses Lake, WA 98837
- Reassigned Medicare billing, Washington enrollment
- 158 clinicians in this Medicare group
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 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.
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.
WINTER PARK, FL 32789
WINTER PARK, FL 32789
WINTER PARK, FL 32789
WINTER PARK, FL 32789
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 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.
Where is Danielle Wallace located?
Danielle Wallace practices at 1801 Lee Rd Ste 165, Winter Park, FL 32789. The listed phone number is (407) 975-0410.
What is Danielle Wallace's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Danielle Wallace enrolled in Medicare?
Yes. Danielle Wallace is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Danielle Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Danielle Wallace reassigns Medicare benefits to 9 organizations: Florida Hospital Medical Group Inc (Orlando, FL), Key West Hma Physician Management, LLC (Cudjoe Key, FL), Mymichigan Medical Center Alma (Ithaca, MI), Mclaren Thumb Region (Bad Axe, MI), Mymichigan Medical Center Gladwin (Gladwin, MI) and 4 more organizations, listed in the Medicare section above. Each 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 Danielle Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Danielle Wallace accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Cigna Healthcare, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 1 other insurer list Danielle 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 Danielle Wallace was last updated on June 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Dr. Danielle Charisse Wallace, M.D. · NPI 1114147006
Pediatrics physician in Winter Park, Florida. Individual provider, active in the CMS NPPES registry since April 26, 2007.
## Identity
- **NPI:** 1114147006 (Entity type: Individual)
- **Enumerated:** April 26, 2007
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** ME129213 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 1801 LEE RD STE 165, Winter Park, FL 32789
- **Phone:** (407) 975-0410 · **Fax:** (407) 975-0413
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 9 organizations under Medicare reassignment (form CMS-855R): Florida Hospital Medical Group Inc (NPI 1225034234, Orlando, FL); Key West Hma Physician Management, LLC (NPI 1871548651, Cudjoe Key, FL); Mymichigan Medical Center Alma (NPI 1679506851, Ithaca, MI); Mclaren Thumb Region (NPI 1245257880, Bad Axe, MI); Mymichigan Medical Center Gladwin (NPI 1073999298, Gladwin, MI); and 4 more · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 13, 2023
- **Other identifiers:** Medicaid 2231891 (WA)
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Source: [NPI Profile](https://npiprofile.com/npi/1114147006) · Data from the CMS NPPES public registry.