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ALLEN WALLACE CRNA
NPI 1295798163
Nurse Anesthetist, Certified Registered in Roosevelt, UT

Active since April 10, 2006
250 W 300 N, ROOSEVELT, UT 84066(435) 722-6163(435) 722-9291 Get Directions Write a Review

NPPES record last updated: November 30, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Allen Wallace Crna NPPES

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

ALLEN WALLACE CRNA (NPI 1295798163) is an individual nurse anesthetist, certified registered in Roosevelt, Utah, licensed in Utah (192839-4406) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1295798163
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameALLEN WALLACECredential: CRNA
Location Address250 W 300 NRoosevelt, UT 84066-2336
Mailing Address250 W 300 NRoosevelt, UT 84066-2336 · (435) 722-6163 · Fax (435) 722-9291
Phone(435) 722-6163
Fax(435) 722-9291
Sole ProprietorNo
Enumeration DateApril 10, 2006
Last NPPES UpdateNovember 30, 2007
✔ NPI 1295798163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in UT · 192839-4406
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
250 W 300 N, Roosevelt, UT 84066
Open in Google Maps ↗

Other Identifiers 1

MedicaidD0808UT

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Allen Wallace Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

2

Medicare enrollment records show Allen Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ubmc Anesthesiology
6.6 mi
Nurse Anesthetist, Certified Registered
250 W 300 N
Roosevelt, UT 84066
  • Reassigned Medicare billing, Utah enrollment
  • 6 clinicians in this Medicare group
NPI 1043643877 (801) 432-2600
Uintah Basin Medical Center
7.3 mi
General Acute Care Hospital
250 W 300 N
Roosevelt, UT 84066
  • Reassigned Medicare billing, Utah enrollment
  • 94 clinicians in this Medicare group
NPI 1871556217 (435) 722-6163

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.

Anesthesia for lens surgery 00142
Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.
12 services12 patients

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.

MRS. VALARIE JEAN HAMBLIN RN, BSN, LCCE
Registered Nurse
250 W 300 N
ROOSEVELT, UT 84066
Duchesne County (435) 722-6150
SHAWN W HAWKINS
Physical Therapist
250 W 300 N
ROOSEVELT, UT 84066
Duchesne County (435) 722-6163
UBMC ANESTHESIOLOGY
Nurse Anesthetist, Certified Registered
250 W 300 N
ROOSEVELT, UT 84066
Duchesne County (801) 432-2600
KERRY ROBERT BAUM JR. MD
Surgery
250 W 300 N, UINTAH BASIN MEDICAL CENTER
ROOSEVELT, UT 84066
Duchesne County (435) 722-4691
ROYCE PORTER
Occupational Therapist
250 W 300 N
ROOSEVELT, UT 84066
Duchesne County (435) 725-7448
GARRISON DOUGLAS BEACH PA
Physician Assistant
250 W 300 N
ROOSEVELT, UT 84066
Duchesne County (435) 722-4691
MR. WESTON ROSS WEAVER RPH
Pharmacist
250 W 300 N
ROOSEVELT, UT 84066
Duchesne County (435) 722-6123
DR. CHRISTIAN BOEKWEG DO
Family Medicine
250 W 300 N
ROOSEVELT, UT 84066
Duchesne County (435) 722-4691

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 Allen Wallace's NPI number?

The NPI number for Allen Wallace is 1295798163. It was assigned to this individual provider in the NPPES registry on April 10, 2006.

Where is Allen Wallace located?

Allen Wallace practices at 250 W 300 N, Roosevelt, UT 84066. The listed phone number is (435) 722-6163.

What is Allen Wallace's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Allen Wallace enrolled in Medicare?

Yes. Allen Wallace is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Allen Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Allen Wallace reassigns Medicare benefits to 2 organizations: Ubmc Anesthesiology (Roosevelt, UT) and Uintah Basin Medical Center (Roosevelt, UT). 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 Allen 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 Allen Wallace was last updated on November 30, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.