KEVIN PETER SCOTT WALLACE MD
NPI 1255309258
Internal Medicine in Menlo Park, CA

Q: What is Kevin Wallace's NPI number?

The NPI number for Kevin Wallace is 1255309258. It was assigned to this individual provider in the NPPES registry on March 8, 2006.

Q: What is Kevin Wallace's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Wallace was last updated on April 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 March 08, 2006PECOS EnrolledAccepts Medicare Assignment

1300 CRANE ST, MENLO PARK, CA 94025(650) 498-6500 Get Directions Write a Review

NPPES record last updated: April 24, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 24, 2024, Jul 24, 2023 (2 updates tracked since 2023).

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About Kevin Peter Scott Wallace Md NPPES

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

KEVIN PETER SCOTT WALLACE MD (NPI 1255309258) is an individual internal medicine provider in Menlo Park, California, licensed in California (C151609) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1988).

NPPES Registry Identity

NPI1255309258

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameKEVIN PETER SCOTT WALLACECredential: MD

Location Address1300 CRANE STMenlo Park, CA 94025-4260

Mailing Address1300 Crane StMenlo Park, CA 94025-4283 · (650) 498-6649 · Fax (650) 326-7931

Phone(650) 498-6500

Sole ProprietorNo

Medical School CMSOtherGraduated 1988

Enumeration DateMarch 8, 2006

Last NPPES UpdateApril 24, 20242 updates tracked since enumeration

NPPES CertifiedApril 24, 2024

✔ NPI 1255309258 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CA · C151609

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1300 CRANE ST, Menlo Park, CA 94025

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Other Identifiers 1

Medicaid0000992201DE

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin Peter Scott Wallace Md 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.

PECOS PAC ID8123082708

PECOS Enrollment IDI20171026000792

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.

Areas of Expertise CMS Part B claims 10

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

560 services223 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

107 services107 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

101 services80 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

100 services67 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

29 services28 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

29 services28 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94025 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

$153.83 typical visit price

range $69.00 – $202.35

Typical copayment $38.45 (range $17.25 – $50.58)

Most-billed visit code 99204

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

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.

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

7 suppliers15 claims44 services$5.40 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

2 suppliers19 claims19 services$185.01 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.

MS. JODIE LYNN PORGES RR, CDE

Dietitian, Registered