MARIA WALLACE APN
NPI 1316688773
Nurse Practitioner - Psychiatric/Mental Health in Marlton, NJ

Q: What is Maria Wallace's NPI number?

The NPI number for Maria Wallace is 1316688773. It was assigned to this individual provider in the NPPES registry on April 7, 2022.

Q: What is Maria Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Maria Wallace was last updated on April 7, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 07, 2022PECOS EnrolledAccepts Medicare Assignment

765 ROUTE 70 E BLDG A100, MARLTON, NJ 08053(856) 797-4721(856) 797-4785 Get Directions Write a Review

NPPES record last updated: April 7, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Maria Wallace Apn NPPES

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

MARIA WALLACE APN (NPI 1316688773) is an individual psychiatric/mental health provider in Marlton, New Jersey, licensed in New Jersey (26NJ01232600) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1316688773

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMARIA WALLACECredential: APN

Location Address765 ROUTE 70 E BLDG A100Marlton, NJ 08053-2341

Mailing Address765 Route 70 E Bldg A100Marlton, NJ 08053-2341 · (856) 797-4721 · Fax (856) 797-4785

Phone(856) 797-4721

Fax(856) 797-4785

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateApril 7, 2022

NPPES CertifiedNovember 22, 2021

✔ NPI 1316688773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in NJ · 26NJ01232600

765 ROUTE 70 E BLDG A100, Marlton, NJ 08053

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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

Maria Wallace Apn 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 ID7810384278

PECOS Enrollment IDI20220503002950

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08053 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

$94.90 typical visit price

range $61.59 – $185.05

Typical copayment $23.72 (range $15.39 – $46.26)

Most-billed visit code 99203

Established Patient

$107.94 typical visit price

range $20.08 – $150.98

Typical copayment $26.98 (range $5.02 – $37.74)

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.

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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.

JAMIE MATTHEWS LPC

Counselor (Professional)