PEGGY LYNN WALLACE ARNP
NPI 1285930123
Nurse Practitioner - Adult Health in Tampa, FL
About Peggy Lynn Wallace Arnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PEGGY LYNN WALLACE ARNP (NPI 1285930123) is an individual adult health provider in Tampa, Florida, licensed in Florida (9274861) and active in the NPI registry since February 2011. She is enrolled in Medicare PECOS, is affiliated with St Josephs Hospital, and is a graduate of Other (2010).
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
Peggy Lynn Wallace Arnp 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 Peggy Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Tampa, FL 33614
- Reassigned Medicare billing, Florida enrollment
- Also billed through NPI 1710036868 (Florida)
- 14 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
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Josephs Hospital
Acute Care Hospitals · Tampa, FLPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 33614 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.
TAMPA, FL 33614
TAMPA, FL 33614
TAMPA, FL 33614
TAMPA, FL 33614
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 Peggy Wallace's NPI number?
The NPI number for Peggy Wallace is 1285930123. It was assigned to this individual provider in the NPPES registry on February 9, 2011.
Where is Peggy Wallace located?
Peggy Wallace practices at 4600 N Habana Ave Suite 15, Tampa, FL 33614. The listed phone number is (813) 870-4460.
What is Peggy Wallace's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Peggy Wallace enrolled in Medicare?
Yes. Peggy 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 Peggy Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Peggy Wallace reassigns Medicare benefits to St. Joseph's Hospital, Inc. (Tampa, FL). 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 Peggy Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Peggy Wallace affiliated with any hospitals?
According to CMS data, Peggy Wallace is affiliated with St Josephs Hospital.
When was this NPI record last updated?
The NPPES record for Peggy Wallace was last updated on May 20, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Peggy Lynn Wallace, ARNP · NPI 1285930123
Adult Health physician in Tampa, Florida. Individual provider, active in the CMS NPPES registry since February 9, 2011.
## Identity
- **NPI:** 1285930123 (Entity type: Individual)
- **Enumerated:** February 9, 2011
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** 9274861 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 4600 N HABANA AVE, SUITE 15, Tampa, FL 33614-7112
- **Phone:** (813) 870-4460
## 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:** St. Joseph's Hospital, Inc. (NPI 1992854038, Tampa, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2010
## Record status
- **NPPES last updated:** May 20, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1285930123) · Data from the CMS NPPES public registry.