MAGGIE MAE WALLACE
NPI 1366098642
Nurse Practitioner - Family in Gulf Shores, AL

Q: What is Maggie Wallace's NPI number?

The NPI number for Maggie Wallace is 1366098642. It was assigned to this individual provider in the NPPES registry on August 13, 2019.

Q: What is Maggie Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: Is Maggie Wallace enrolled in Medicare?

No. Maggie Wallace has opted out of Medicare through June 12, 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.

Q: When was this NPI record last updated?

The NPPES record for Maggie Wallace was last updated on November 13, 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.

Active since August 13, 2019Opted out of Medicare · through Jun 12, 2028

87.47/100

CMS Quality Rating

200 OFFICE PARK DR, GULF SHORES, AL 36542(251) 968-7379(251) 968-5960 Get Directions Write a Review

NPPES record last updated: November 13, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Nov 13, 2023, Aug 13, 2019 (2 updates tracked since 2019).

On this page

About Maggie Mae Wallace NPPES

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

MAGGIE MAE WALLACE (NPI 1366098642) is an individual family provider in Gulf Shores, Alabama, licensed in Alabama (1-182953) and active in the NPI registry since August 2019. She has opted out of Medicare through June 12, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1366098642

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMAGGIE MAE WALLACE

Location Address200 OFFICE PARK DRGulf Shores, AL 36542-3432

Mailing Address200 Office Park DrGulf Shores, AL 36542-3432 · (512) 968-7379 · Fax (251) 968-5960

Phone(251) 968-7379

Fax(251) 968-5960

Sole ProprietorNo

Enumeration DateAugust 13, 2019

Last NPPES UpdateNovember 13, 20232 updates tracked since enumeration

NPPES CertifiedNovember 13, 2023

✔ NPI 1366098642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in AL · 1-182953✔ Licensed in CT · 8373

200 OFFICE PARK DR, Gulf Shores, AL 36542

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Maggie Mae Wallace 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 June 12, 2024 through June 12, 2028.

Opt-Out Effective DateJune 12, 2024

Opt-Out In Effect ThroughJune 12, 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.

Areas of Expertise CMS Part B claims 5

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 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.

56 services50 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

36 services11 patients

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.

28 services26 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

15 services11 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36542 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

$81.90 typical visit price

range $52.65 – $161.63

Typical copayment $20.47 (range $13.16 – $40.40)

Most-billed visit code 99203

Established Patient

$93.72 typical visit price

range $16.56 – $131.65

Typical copayment $23.43 (range $4.14 – $32.91)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.47/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

74.95

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAVANNAH AXT

Behavior Technician