SUSAN L. WALLACE MD
NPI 1255402160
Psychiatry & Neurology - Psychiatry in Panorama City, CA
About Susan L. Wallace Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUSAN L. WALLACE MD (NPI 1255402160) is an individual psychiatry provider in Panorama City, California, licensed in California (G42602) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of New York Medical College (1979).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 3
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
Susan L. 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.
Medicare Billing Reassignments
4Medicare enrollment records show Susan Wallace reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Lebec, CA 93243
- Reassigned Medicare billing, California enrollment
- Also billed through NPI 1669621447 (California)
- 264 clinicians in this Medicare group
Fresno, CA 93720
- Reassigned Medicare billing, California enrollment
- 142 clinicians in this Medicare group
Twin Bridges, CA 95735
- Reassigned Medicare billing, California enrollment
- 126 clinicians in this Medicare group
South Lake Tahoe, CA 96150
- Reassigned Medicare billing, California enrollment
- 100 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 91402 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PANORAMA CITY, CA 91402
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 Susan Wallace's NPI number?
The NPI number for Susan Wallace is 1255402160. It was assigned to this individual provider in the NPPES registry on November 13, 2006.
Where is Susan Wallace located?
Susan Wallace practices at 13652 Cantara St, Panorama City, CA 91402. The listed phone number is (818) 375-2000.
What is Susan Wallace's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.
Is Susan Wallace enrolled in Medicare?
Yes. Susan 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 organizations bill Medicare for Susan Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Susan Wallace reassigns Medicare benefits to 4 organizations: Clinica Sierra Vista (Lebec, CA), Camarena Health (Fresno, CA), Barton Healthcare System (Twin Bridges, CA) and Tahoe Carson Valley Medical Group Inc (South Lake Tahoe, CA). 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 Susan 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 Susan Wallace was last updated on April 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Susan L. Wallace, MD · NPI 1255402160
Psychiatry physician in Panorama City, California. Individual provider, active in the CMS NPPES registry since November 13, 2006.
## Identity
- **NPI:** 1255402160 (Entity type: Individual)
- **Enumerated:** November 13, 2006
- **Primary specialty:** Psychiatry & Neurology - Psychiatry · taxonomy 2084P0800X
- **State license:** G42602 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 13652 CANTARA ST, Panorama City, CA 91402-5423
- **Phone:** (818) 375-2000
## 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:** 4 organizations under Medicare reassignment (form CMS-855R): Clinica Sierra Vista (NPI 1265652697, Lebec, CA); Camarena Health (NPI 1841815347, Fresno, CA); Barton Healthcare System (NPI 1114033529, Twin Bridges, CA); Tahoe Carson Valley Medical Group Inc (NPI 1508865528, South Lake Tahoe, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** New York Medical College, class of 1979
## Record status
- **NPPES last updated:** April 9, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1255402160) · Data from the CMS NPPES public registry.