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KACEY L WALLACE DO
NPI 1306868534
Family Medicine in Chickasha, OK

Active since July 24, 2006Opted out of Medicare · through Jul 22, 2028
1000 W CHOCTAW AVE STE 9, CHICKASHA, OK 73018(405) 544-2940(405) 337-9632 Get Directions Write a Review

NPPES record last updated: November 24, 2023. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Nov 24, 2023, Jun 11, 2020, Aug 16, 2016 (3 updates tracked since 2016).

About Kacey L Wallace Do NPPES

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

KACEY L WALLACE DO (NPI 1306868534) is an individual family medicine provider in Chickasha, Oklahoma, licensed in Oklahoma (4339) and active in the NPI registry since July 2006. She has opted out of Medicare through July 22, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1306868534
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKACEY L WALLACECredential: DO
Location Address1000 W CHOCTAW AVE STE 9Chickasha, OK 73018
Mailing Address1000 W Choctaw Ave Ste 9Chickasha, OK 73018 · (405) 544-2940 · Fax (405) 337-9632
Phone(405) 544-2940
Fax(405) 337-9632
Sole ProprietorNo
Enumeration DateJuly 24, 2006
Last NPPES UpdateNovember 24, 20233 updates tracked since enumeration
NPPES CertifiedJune 11, 2020
✔ NPI 1306868534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OK · 4339
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.
1000 W CHOCTAW AVE STE 9, Chickasha, OK 73018
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Other Identifiers 2

OtherP00331218OK · Medicare Rail Road
Medicaid200077860AOK

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kacey L Wallace Do has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 22, 2022 through July 22, 2028.

Opt-Out Effective DateJuly 22, 2022
Opt-Out In Effect ThroughJuly 22, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73018 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
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
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 20

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
8 suppliers28 claims67 services$6.39 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers44 claims44 services$33.94 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
5 suppliers38 claims38 services$77.00 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
5 suppliers34 claims96 services$30.08 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers16 claims67 services$10.76 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
6 suppliers26 claims26 services$43.94 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Kacey Wallace's NPI number?

The NPI number for Kacey Wallace is 1306868534. It was assigned to this individual provider in the NPPES registry on July 24, 2006.

Where is Kacey Wallace located?

Kacey Wallace practices at 1000 W Choctaw Ave Ste 9, Chickasha, OK 73018. The listed phone number is (405) 544-2940.

What is Kacey Wallace's specialty?

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

Is Kacey Wallace enrolled in Medicare?

No. Kacey Wallace has opted out of Medicare through July 22, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kacey Wallace was last updated on November 24, 2023. 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.