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DR. ADAM DONALD WALLACE MD
NPI 1386969079
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Rochester, MN

Active since April 06, 2010PECOS Enrolled
200 1ST ST SW, ROCHESTER, MN 55905(507) 284-2511 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 5, 2026, Dec 8, 2021, May 27, 2021 and 4 more (7 updates tracked since 2017).

About Dr. Adam Donald Wallace Md NPPES

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

DR. ADAM DONALD WALLACE MD (NPI 1386969079) is an individual neurology with special qualifications in child neurology provider in Rochester, Minnesota, licensed in Wisconsin (67056-20) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1386969079
Entity TypeIndividualMale
Primary Taxonomy2084N0402X
Provider Legal NameDR. ADAM DONALD WALLACECredential: MD
Location Address200 1ST ST SWRochester, MN 55905
Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531 · (608) 829-5485
Phone(507) 284-2511
Sole ProprietorNo
Enumeration DateApril 6, 2010
Last NPPES UpdateMay 5, 20267 updates tracked since enumeration
NPPES CertifiedMay 5, 2026
✔ NPI 1386969079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0402X
Licenses✔ Licensed in WI · 67056-20✔ Licensed in IL · 036145300
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License 036145300 (IL), 67056-20 (WI)
200 1ST ST SW, Rochester, MN 55905
Open in Google Maps ↗

Secondary Practice Locations 4

Location 1200 1st St SWRochester, MN 55905 · Phone (507) 284-2511
Location 2744 S Webster AveGreen Bay, WI 54301-3505 · Phone (920) 445-7222 · Fax (920) 445-7289
Location 38201 E Riverside BlvdRockford, IL 61114-2300 · Phone (815) 971-2000
Location 41836 South AveLA Crosse, WI 54601-5429 · Phone (608) 782-7300

Other Identifiers 1

Medicaid1386969079WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, CareSource (Common Ground Healthcare), Dean Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Adam Donald Wallace Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

7

Medicare enrollment records show Adam Wallace reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Gundersen Lutheran Medical Center Inc
63 mi
Clinic/Center
1111 7TH ST S
La Crosse, WI 54601
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,457 clinicians in this Medicare group
NPI 1225873458 (608) 782-7300
University Of Wisconsin Medical Foundation, Inc
153 mi
Multi-Specialty
425 WIND RIDGE DR
Wausau, WI 54401
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2,832 clinicians in this Medicare group
NPI 1033433495 (715) 675-5201
Dean Health Systems, Inc
168 mi
Allergy & Immunology
1211 FISH HATCHERY RD
Madison, WI 53715
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,377 clinicians in this Medicare group
NPI 1053358846 (608) 252-8000
St Vincent Hospital-Hospital Sisters-Third Order Of St Francis
194 mi
Otolaryngology
100 COUNTY ROAD B
Shawano, WI 54166
  • Reassigned Medicare billing, Wisconsin enrollment
  • 742 clinicians in this Medicare group
NPI 1194314013 (920) 496-4700
Rockford Health Physicians
208 mi
Anesthesiology
2400 N ROCKTON AVE
Rockford, IL 61103
  • Reassigned Medicare billing, Illinois enrollment
  • 1,375 clinicians in this Medicare group
NPI 1023275278 (815) 971-5000
Aurora Medical Group, Inc.
234 mi
Obstetrics & Gynecology
8905 W LINCOLN AVE, SUITE 515
West Allis, WI 53227
  • Reassigned Medicare billing, Wisconsin enrollment
  • 4,609 clinicians in this Medicare group
NPI 1457592735 (414) 328-8650
St. Nicholas Hospital-Sisters Of The Third Order Of St Francis
236 mi
Internal Medicine
3113 SAEMANN AVE
Sheboygan, WI 53081
  • Reassigned Medicare billing, Wisconsin enrollment
  • 673 clinicians in this Medicare group
NPI 1275799413 (920) 496-4700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55905 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
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

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.

EMILY LEASURE MD
Internal Medicine
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
NATHANAEL BAILEY
Pathology (Clinical Pathology/Laboratory Medicine)
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
NICOLE S NIPPER NP
Nurse Practitioner
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
BRANDI D'SOUZA NP
Nurse Practitioner
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
DR. JODI M. MOORE-WEISS OD
Optometrist
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
JENNIFER L KERKVLIET MA
Psychologist
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
EMMANUEL J LUJERO CRNA
Nurse Anesthetist, Certified Registered
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
JUAN PABLO BRITO CAMPANA M.D
Internal Medicine (Endocrinology, Diabetes & Metabolism)
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511

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 Adam Wallace's NPI number?

The NPI number for Adam Wallace is 1386969079. It was assigned to this individual provider in the NPPES registry on April 6, 2010.

Where is Adam Wallace located?

Adam Wallace practices at 200 1st St SW, Rochester, MN 55905. The listed phone number is (507) 284-2511.

What is Adam Wallace's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

Is Adam Wallace enrolled in Medicare?

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

Which organizations bill Medicare for Adam Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Adam Wallace reassigns Medicare benefits to 7 organizations: Gundersen Lutheran Medical Center Inc (La Crosse, WI), University Of Wisconsin Medical Foundation, Inc (Wausau, WI), Dean Health Systems, Inc (Madison, WI), St Vincent Hospital-Hospital Sisters-Third Order Of St Francis (Shawano, WI), Rockford Health Physicians (Rockford, IL) and 2 more organizations, listed in the Medicare section above. 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 Adam Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Adam Wallace accept?

Health plans from Aspirus Health Plan, CareSource (Common Ground Healthcare), Dean Health Plan, Group Health Cooperative-SCW and HealthPartners and 1 other insurer list Adam Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Adam Wallace was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.