DR. TASHA B WALLACE D.O.
NPI 1396736997
Family Medicine in Fort Myers, FL

Q: What is Tasha Wallace's NPI number?

The NPI number for Tasha Wallace is 1396736997. It was assigned to this individual provider in the NPPES registry on November 2, 2005.

Q: What is Tasha Wallace's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Tasha Wallace was last updated on August 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.

Active since November 02, 2005PECOS EnrolledAccepts Medicare Assignment

94.11/100

CMS Quality Rating

14651 PALM BEACH BLVD STE 100, FORT MYERS, FL 33905(239) 369-2903(239) 369-0500 Get Directions Write a Review

NPPES record last updated: August 27, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Tasha B Wallace D.o. NPPES

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

DR. TASHA B WALLACE D.O. (NPI 1396736997) is an individual family medicine provider in Fort Myers, Florida, licensed in Florida (OS8622) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS, is affiliated with Lee Memorial Hospital, and is a graduate of Rowan University School Of Osteopathic Medicine (2000).

NPPES Registry Identity

NPI1396736997

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. TASHA B WALLACECredential: D.O.

Location Address14651 PALM BEACH BLVD STE 100Fort Myers, FL 33905-2331

Mailing Address14651 Palm Beach Blvd Ste 100Fort Myers, FL 33905-2331 · (239) 369-2903 · Fax (239) 369-0500

Phone(239) 369-2903

Fax(239) 369-0500

Sole ProprietorNo

Medical School CMSRowan University School Of Osteopathic MedicineGraduated 2000

Enumeration DateNovember 2, 2005

Last NPPES UpdateAugust 27, 2024

NPPES CertifiedAugust 27, 2024

✔ NPI 1396736997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · OS8622

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.

14651 PALM BEACH BLVD STE 100, Fort Myers, FL 33905

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.Insurance ›

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

Dr. Tasha B Wallace D.o. 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 ID3173626835

PECOS Enrollment IDI20070317000058

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.

Areas of Expertise CMS Part B claims 12

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.

733 services320 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.

327 services203 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.

159 services159 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

42 services31 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

24 services20 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

24 services16 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

19 services19 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

18 services17 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

16 services15 patients

Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage 90694

The quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.

12 services12 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

12 services12 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lee Memorial Hospital

Acute Care Hospitals · Fort Myers, FL

5/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100012

Location2776 Cleveland AveFort Myers, FL 33901 · Lee County

Emergency services Birthing friendly

Cape Coral Hospital

Acute Care Hospitals · Cape Coral, FL

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100244

Location636 Del Prado BlvdCape Coral, FL 33990 · Lee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33905 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

$91.69 typical visit price

range $58.56 – $179.05

Typical copayment $22.92 (range $14.64 – $44.76)

Most-billed visit code 99203

Established Patient

$103.21 typical visit price

range $18.44 – $144.68

Typical copayment $25.80 (range $4.61 – $36.17)

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.

94.11/100

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

Individually scored

Quality

94.2

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Advance Care Plan

43%824 patients2/55-star benchmark: 100%

Breast Cancer Screening

74%615 patients4/55-star benchmark: 93%

Cervical Cancer Screening

42%695 patients2/55-star benchmark: 98%

Colorectal Cancer Screening

35%1,200 patients2/55-star benchmark: 88%

Controlling High Blood Pressure

71%824 patients4/55-star benchmark: 91%

Diabetes: Eye Exam

8%301 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

28%301 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

98%6,036 patients4/55-star benchmark: 100%

e-Prescribing

96%1,512 patients3/55-star benchmark: 100%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

32%3,037 patients3/55-star benchmark: 61%

Provide Patients Electronic Access to Their Health Information

44%1,153 patients2/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

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

7 suppliers20 claims43 services$6.50 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers13 claims17 services$1.20 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier12 claims12 services$185.34 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 2

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

PHYSICIANS' PRIMARY CARE OF SOUTHWEST FLORIDA, P.L.

Family Medicine

14651 PALM BEACH BLVD STE 100
FORT MYERS, FL 33905

Lee County (239) 369-2903

CALOOSA MEDICAL CENTER, LLC

Family Medicine

14651 PALM BEACH BLVD STE 100
FORT MYERS, FL 33905

Lee County (239) 849-6620

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 Tasha Wallace's NPI number?

The NPI number for Tasha Wallace is 1396736997. It was assigned to this individual provider in the NPPES registry on November 2, 2005.

Where is Tasha Wallace located?

Tasha Wallace practices at 14651 Palm Beach Blvd Ste 100, Fort Myers, FL 33905. The listed phone number is (239) 369-2903.

What is Tasha Wallace's specialty?

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

Is Tasha Wallace enrolled in Medicare?

Yes. Tasha Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Tasha Wallace accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and UnitedHealthcare list Tasha 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.

Is Tasha Wallace affiliated with any hospitals?

According to CMS data, Tasha Wallace is affiliated with Lee Memorial Hospital and Cape Coral Hospital.

When was this NPI record last updated?

The NPPES record for Tasha Wallace was last updated on August 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.