DR. ADAM DONALD WALLACE MD
NPI 1386969079
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Rochester, MN
NPI Status: Active since April 06, 2010
Contact Information
200 1ST ST SW
ROCHESTER, MN
ZIP 55905
Phone: (507) 284-2511
- Individual
- Male
- Psychiatry & Neurology
- Neurology with Special Qualifications in...
- Accepts Insurance
- PECOS Enrolled
About ADAM WALLACE
This page provides the complete NPI Profile along with additional information for Adam Wallace, a provider established in Rochester, Minnesota with a medical specialization in Psychiatry & Neurology, focusing in neurology with special qualifications in child neurology . The healthcare provider is registered in the NPI registry with number 1386969079 assigned on April 2010. The practitioner's primary taxonomy code is 2084N0402X with license number 67056-20 (WI). The provider is registered as an individual and his NPI record was last updated May 2026.
- NPI
- 1386969079
- Provider Name
- DR. ADAM DONALD WALLACE MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 200 1ST ST SW ROCHESTER, MN 55905
- Location Phone
- (507) 284-2511
- Mailing Address
- 7974 UW HEALTH CT MIDDLETON, WI 53562
- Mailing Phone
- (608) 829-5485
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-06-2010
- Last Update Date
- 05-05-2026
- Code Navigator
Location Map
Secondary Locations
- 200 1st St SW
Rochester, MN 55905
(507) 284-2511 - 744 S Webster Ave
Green Bay, WI 54301
(920) 445-7222 - 8201 E Riverside Blvd
Rockford, IL 61114
(815) 971-2000 - 1836 South Ave
LA Crosse, WI 54601
(608) 782-7300
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology
- Taxonomy Code
- 2084N0402X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 67056-20
- License State
- WI
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 036145300 (IL) |
| 2 | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 67056-20 (WI) |
| 3 | 2084N0402X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 036145300 (IL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- HMO Bronze $0 Medical Deductible - HMO
- HMO Bronze 10000 - HMO
- HMO Bronze 7500 - HMO
- HMO Catastrophic 10600 with 3 free PCP visits - HMO
- HMO Gold 2000 - HMO
- HMO Gold 2700 - HMO
- HMO HDHP Silver 5900 - HMO
- HMO Silver 6000 - HMO
- HMO Silver 6600 - HMO
- POS Bronze 7500 - POS
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
- Better Together HMO Bronze 6500 Ded/8750 MOOP HSA - HMO
- Better Together HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
- Better Together HMO Bronze No Medical Ded/10600 MOOP HSA - HMO
- Better Together HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
- Better Together HMO Gold 2000 Ded/8200 MOOP - HMO
- Better Together HMO Gold 4000 Ded/4000 MOOP HSA - HMO
- Better Together HMO Platinum 750 Ded/2000 MOOP with Vision - HMO
- Better Together HMO Platinum No Ded/3300 MOOP - HMO
- Better Together HMO Platinum No Ded/5200 MOOP - HMO
- Better Together HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
- Atlas $1,300 Gold - PPO
- Atlas $2,000 Standard Gold - PPO
- Atlas $3,050 Plus Silver - PPO
- Atlas $3,800 HSA Silver - PPO
- Atlas $6,000 Standard Silver - PPO
- Atlas $6,800 Plus Bronze HSA - PPO
- Atlas $7,500 Standard Bronze HSA - PPO
- Atlas $8,400 HSA Bronze - PPO
- Oak $1,300 Gold - PPO
- Oak $2,000 Standard Gold - PPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - EPO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - EPO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - EPO
- Medica Individual Choice Gold Share - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1386969079 | MEDICAID (05) | WI |
Medicare Participation & PECOS Enrollment Status
Adam Wallace is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 55905 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $127.61
- Minimum New Patient Price $56
- Maximum New Patient Price $168.28
- Average New Patient Copayment $31.9
- Minimum New Patient Copayment $14
- Maximum New Patient Copayment $42.07
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $98.61
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $138.04
- Average Established Patient Copayment $24.65
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $34.51
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1386969079, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
ROCHESTER, MN 55905
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386969079, enumerated as an "individual" on April 06, 2010.
The provider is located at 200 1ST ST SW ROCHESTER, MN 55905 and the phone number is (507) 284-2511.
Psychiatry & Neurology with taxonomy code 2084N0402X and a focus in Neurology with Special Qualifications in Child Neurology.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus Health. Please consult your insurance carrier or call the provider to verify.
