WALLACE BLAKE MCKINNEY M.D.
NPI 1174790224
Emergency Medicine in Sacramento, CA
About Wallace Blake Mckinney M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WALLACE BLAKE MCKINNEY M.D. (NPI 1174790224) is an individual emergency medicine provider in Sacramento, California, licensed in California (A105593) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS and is a graduate of Other (2007).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Wallace Blake Mckinney M.d. 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.
Medicare Billing Reassignments
5Medicare enrollment records show Wallace Mckinney reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Concord, CA 94520
- Reassigned Medicare billing, California enrollment
- 2,323 clinicians in this Medicare group
Sacramento, CA 95816
- Reassigned Medicare billing, California enrollment
- 73 clinicians in this Medicare group
Roseville, CA 95661
- Reassigned Medicare billing, California enrollment
- 40 clinicians in this Medicare group
Garberville, CA 95542
- Reassigned Medicare billing, California enrollment
- Also billed through NPI 1003819376 (California)
- 89 clinicians in this Medicare group
Denver, CO 80205
- Reassigned Medicare billing, Ohio enrollment
- Medicare enrollment name: Cirrusmd Medical Group Of Delaware PA
- 24 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.
Areas of Expertise CMS Part B claims 7
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95817 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
SACRAMENTO, CA 95817
SACRAMENTO, CA 95817
SACRAMENTO, CA 95817
SACRAMENTO, CA 95817
SACRAMENTO, CA 95817
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 Wallace Mckinney's NPI number?
The NPI number for Wallace Mckinney is 1174790224. It was assigned to this individual provider in the NPPES registry on May 8, 2008.
Where is Wallace Mckinney located?
Wallace Mckinney practices at 4150 V St Pssb 2100, Sacramento, CA 95817. The listed phone number is (916) 734-8571.
What is Wallace Mckinney's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Wallace Mckinney enrolled in Medicare?
Yes. Wallace Mckinney is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Wallace Mckinney's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Wallace Mckinney reassigns Medicare benefits to 5 organizations: Cep America - California (Concord, CA), Vituity-California Observation Services PC (Sacramento, CA), Vitalen Inpatient Care PC (Roseville, CA), Southern Humboldt Community Healthcare District (Garberville, CA) and Cirrusmd Medical Group Of Delaware, P.A. (Denver, CO). 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 Wallace Mckinney's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Wallace Mckinney was last updated on September 24, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Wallace Blake Mckinney, M.D. · NPI 1174790224
Emergency Medicine physician in Sacramento, California. Individual provider, active in the CMS NPPES registry since May 8, 2008.
## Identity
- **NPI:** 1174790224 (Entity type: Individual)
- **Enumerated:** May 8, 2008
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** A105593 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4150 V ST, PSSB 2100, Sacramento, CA 95817-1460
- **Phone:** (916) 734-8571 · **Fax:** (916) 734-7950
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Cep America - California (NPI 1538180807, Concord, CA); Vituity-California Observation Services PC (NPI 1447148705, Sacramento, CA); Vitalen Inpatient Care PC (NPI 1134069198, Roseville, CA); Southern Humboldt Community Healthcare District (NPI 1336367515, Garberville, CA); Cirrusmd Medical Group Of Delaware, P.A. (NPI 1922664200, Denver, CO) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2007
## Record status
- **NPPES last updated:** September 24, 2008
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Source: [NPI Profile](https://npiprofile.com/npi/1174790224) · Data from the CMS NPPES public registry.