DR. MARY ANDERSON WALLACE M.D.
NPI 1215109228
Hospitalist in Colorado Springs, CO
About Dr. Mary Anderson Wallace M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MARY ANDERSON WALLACE M.D. (NPI 1215109228) is an individual hospitalist provider in Colorado Springs, Colorado, licensed in Colorado (DR.0049780) and active in the NPI registry since March 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2008).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 2
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
Dr. Mary Anderson Wallace 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 Reassignment
Medicare enrollment records show Mary Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Denver, CO 80247
- Reassigned Medicare billing, Colorado enrollment
- Medicare enrollment name: Colorado Permanente Medical Group PC
- 1,715 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 80909 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
COLORADO SPRINGS, CO 80909
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 Mary Wallace's NPI number?
The NPI number for Mary Wallace is 1215109228. It was assigned to this individual provider in the NPPES registry on March 31, 2008. The provider is also known as Mary Elizabeth Anderson M.D..
Where is Mary Wallace located?
Mary Wallace practices at 1400 E Boulder St, Colorado Springs, CO 80909. The listed phone number is (303) 338-4545.
What is Mary Wallace's specialty?
The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.
Is Mary Wallace enrolled in Medicare?
Yes. Mary Wallace 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 organization bills Medicare for Mary Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Wallace reassigns Medicare benefits to Colorado Permanente Medical Group, P.C. (Denver, CO). 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 Mary Wallace'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 Mary Wallace was last updated on September 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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. Mary Anderson Wallace, M.D. · NPI 1215109228
Hospitalist physician in Colorado Springs, Colorado. Individual provider, active in the CMS NPPES registry since March 31, 2008.
## Identity
- **NPI:** 1215109228 (Entity type: Individual)
- **Enumerated:** March 31, 2008
- **Primary specialty:** Hospitalist · taxonomy 208M00000X
- **State license:** DR.0049780 (Colorado)
- **Sole proprietor:** No
## Practice location
- **Address:** 1400 E BOULDER ST, Colorado Springs, CO 80909-5533
- **Phone:** (303) 338-4545
## 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:** Colorado Permanente Medical Group, P.C. (NPI 1760599724, Denver, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2008
## Record status
- **NPPES last updated:** September 27, 2021
- **Other identifiers:** Medicaid 94831076 (CO); Other 029236 (CO)
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Source: [NPI Profile](https://npiprofile.com/npi/1215109228) · Data from the CMS NPPES public registry.