DR. DANIEL LELAND WALLACE DO
NPI 1275525875
Family Medicine in Grand Rapids, MI

Q: What is Daniel Wallace's NPI number?

The NPI number for Daniel Wallace is 1275525875. It was assigned to this individual provider in the NPPES registry on August 19, 2005.

Q: What is Daniel Wallace's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Daniel Wallace was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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 August 19, 2005PECOS EnrolledAccepts Medicare Assignment

275 MICHIGAN ST NE, GRAND RAPIDS, MI 49503(616) 267-0800(616) 267-0801 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Dr. Daniel Leland Wallace Do NPPES

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

DR. DANIEL LELAND WALLACE DO (NPI 1275525875) is an individual family medicine provider in Grand Rapids, Michigan, licensed in Michigan (5101011648) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Michigan State University College Of Osteopathic Medicine (1992).

NPPES Registry Identity

NPI1275525875

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. DANIEL LELAND WALLACECredential: DO

Location Address275 MICHIGAN ST NEGrand Rapids, MI 49503-2531

Mailing Address100 Michigan St Ne # Mc-845Grand Rapids, MI 49503-2560 · (616) 267-0800 · Fax (616) 267-0801

Phone(616) 267-0800

Fax(616) 267-0801

Sole ProprietorNo

Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 1992

Enumeration DateAugust 19, 2005

Last NPPES UpdateJanuary 22, 2025

NPPES CertifiedJanuary 22, 2025

✔ NPI 1275525875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 5101011648

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

275 MICHIGAN ST NE, Grand Rapids, MI 49503

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

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

Dr. Daniel Leland Wallace Do 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 ID5496841561

PECOS Enrollment IDI20071019000640

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 2

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 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.

27 services20 patients

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.

16 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230038

Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49503 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $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.

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.

PHILLIP RICHTER PARAS M.D.

Pediatrics