AMANDA GAIL WALLACE
NPI 1154844041
Nurse Practitioner - Family in West Union, OH

Q: What is Amanda Wallace's NPI number?

The NPI number for Amanda Wallace is 1154844041. It was assigned to this individual provider in the NPPES registry on July 21, 2017.

Q: What is Amanda Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Wallace was last updated on May 5, 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.

Active since July 21, 2017PECOS Enrolled

247 CIC BLVD, WEST UNION, OH 45693(513) 941-4999(513) 694-0168 Get Directions Write a Review

NPPES record last updated: May 5, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 5, 2023, May 1, 2018, Sep 12, 2017 and 1 more (4 updates tracked since 2017).

On this page

About Amanda Gail Wallace NPPES

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

AMANDA GAIL WALLACE (NPI 1154844041) is an individual family provider in West Union, Ohio, licensed in Ohio (APRN.CNP.021126) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154844041

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameAMANDA GAIL WALLACE

Location Address247 CIC BLVDWest Union, OH 45693-7512

Mailing Address6460 Harrison Ave Ste 200Cincinnati, OH 45247-7958 · (513) 941-4999 · Fax (513) 694-0168

Phone(513) 941-4999

Fax(513) 694-0168

Sole ProprietorNo

Enumeration DateJuly 21, 2017

Last NPPES UpdateMay 5, 20234 updates tracked since enumeration

NPPES CertifiedMay 5, 2023

✔ NPI 1154844041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in OH · APRN.CNP.021126✔ Licensed in KY · 3011658

Also ListedRegistered NurseTaxonomy 163W00000X · License RN.300987 (OH), 1155351 (KY)

247 CIC BLVD, West Union, OH 45693

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Other Identifiers 2

Medicaid0241010OH

Medicaid7100477320KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, CareSource (Common Ground Healthcare), Oscar Health Insurance and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Gail Wallace 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 Amanda Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Signify Health, LLC

847 mi

General Practice

4055 VALLEY VIEW LN STE 700
Dallas, TX 75244

Reassigned Medicare billing, Kentucky and Ohio enrollments
390 clinicians in this Medicare group

NPI 1689158487 (469) 466-7007

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 45693 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

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

46%65 patients3/55-star benchmark: 92%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

32%109 patients2/55-star benchmark: 85%

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

30%44 patients2/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

99%1,490 patients5/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

1%298 patients1/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

100%79 patients5/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

69%358 patients3/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

14%320 patients1/55-star benchmark: 88%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

100%358 patients5/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

5%358 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

26%358 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

13 suppliers32 claims97 services$6.21 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

3 suppliers46 claims46 services$178.77 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

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