AMY ANN WALLACE OTR-L
NPI 1467517466
Occupational Therapist in South Lake Tahoe, CA

Active since December 27, 2006Accepts Medicare Assignment
10539 PROFESSIONAL CIR, SUITE 201, SOUTH LAKE TAHOE, CA 96150(775) 348-8800(833) 687-1419 Get Directions Write a Review

NPPES record last updated: July 24, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 24, 2023, Mar 17, 2018, Oct 27, 2017 (3 updates tracked since 2017).

About Amy Ann Wallace Otr-l NPPES

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

AMY ANN WALLACE OTR-L (NPI 1467517466) is an individual occupational therapist in South Lake Tahoe, California, licensed in Nevada (0721) and active in the NPI registry since December 2006. She maintains 6 additional practice locations and is a graduate of Other (2000).

NPPES Registry Identity

NPI1467517466
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameAMY ANN WALLACECredential: OTR-L
Location Address10539 PROFESSIONAL CIR, SUITE 201South Lake Tahoe, CA 96150-3828
Mailing AddressPo Box 9578South Lake Tahoe, CA 96158 · (530) 543-5896 · Fax (530) 544-6512
Fax(833) 687-1419
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateDecember 27, 2006
Last NPPES UpdateJuly 24, 20233 updates tracked since enumeration
NPPES CertifiedJuly 20, 2023
NPI 1467517466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
Licenses Licensed in NV · 0721 Licensed in CA · 3665
Definition

An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

10539 PROFESSIONAL CIR, South Lake Tahoe, CA 96150

Secondary Practice Locations 6

Location 12170 South AveSouth Lake Tahoe, CA 96150-7026 · Phone (530) 543-5896 · Fax (530) 544-6512
Location 21139 3rd StSouth Lake Tahoe, CA 96150-3465 · Phone (530) 543-5706 · Fax (530) 541-4130
Location 3780 Vista Blvd Ste 100Sparks, NV 89434-6677 · Phone (775) 348-8800 · Fax (833) 687-1419
Location 4935 Mica Dr Ste 13Carson City, NV 89705-7181 · Phone (775) 783-3065 · Fax (775) 267-1829
Location 5155 Highway 50 Fl 2Stateline, NV 89449-9816 · Phone (775) 589-8953 · Fax (775) 589-8920
Location 61749 N Stewart St Ste 50Carson City, NV 89706-2574 · Phone (775) 348-8800 · Fax (833) 687-1419

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

Amy Ann Wallace Otr-l 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 ID5799020871
PECOS Enrollment IDI20181218001251

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 Amy Wallace's NPI number?

The NPI number for Amy Wallace is 1467517466. It was assigned to this individual provider in the NPPES registry on December 27, 2006.

Where is Amy Wallace located?

Amy Wallace practices at 10539 Professional Cir Suite 201, South Lake Tahoe, CA 96150. The listed phone number is (775) 348-8800.

What is Amy Wallace's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Amy Wallace enrolled in Medicare?

Yes. Amy 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 Amy Wallace was last updated on July 24, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.