BRIAN WALLACE N.P.
NPI 1457561615
Nurse Practitioner - Primary Care in Tyler, TX

Active since May 23, 2007PECOS EnrolledAccepts Medicare Assignment
1910 ROSELAND BLVD, TYLER, TX 75701(903) 533-0644 Get Directions Write a Review

NPPES record last updated: March 12, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Brian Wallace N.p. NPPES

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

BRIAN WALLACE N.P. (NPI 1457561615) is an individual primary care provider in Tyler, Texas, licensed in Colorado (RN 169685C) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1457561615
Entity TypeIndividualMale
Primary Taxonomy363LP2300X
Provider Legal NameBRIAN WALLACECredential: N.P.
Location Address1910 ROSELAND BLVDTyler, TX 75701-4246
Mailing Address1910 Roseland BlvdTyler, TX 75701-4246 · (903) 533-0644 · Fax (903) 533-0441
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateMay 23, 2007
Last NPPES UpdateMarch 12, 2010
NPI 1457561615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License Licensed in CO · RN 169685C
1910 ROSELAND BLVD, Tyler, TX 75701

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

Brian Wallace N.p. 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 ID6103913389
PECOS Enrollment IDI20220714000066
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 3

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.
64 services34 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.
28 services28 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.
18 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Nurse Practitioner (Family)
1910 ROSELAND BLVD
TYLER, TX 75701
Physician Assistant
1910 ROSELAND BLVD
TYLER, TX 75701
Nurse Practitioner (Family)
1910 ROSELAND BLVD
TYLER, TX 75701
Nurse Practitioner (Family)
1910 ROSELAND BLVD
TYLER, TX 75701
Internal Medicine
1910 ROSELAND BLVD
TYLER, TX 75701
Family Medicine
1910 ROSELAND BLVD
TYLER, TX 75701
Internal Medicine
1910 ROSELAND BLVD
TYLER, TX 75701
Internal Medicine
1910 ROSELAND BLVD
TYLER, TX 75701

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 Brian Wallace's NPI number?

The NPI number for Brian Wallace is 1457561615. It was assigned to this individual provider in the NPPES registry on May 23, 2007.

Where is Brian Wallace located?

Brian Wallace practices at 1910 Roseland Blvd, Tyler, TX 75701. The listed phone number is (903) 533-0644.

What is Brian Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Brian Wallace enrolled in Medicare?

Yes. Brian 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.

When was this NPI record last updated?

The NPPES record for Brian Wallace was last updated on March 12, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.