KELLI P WALLACE MD
NPI 1518939867
Family Medicine in Fort Dodge, IA
About Kelli P Wallace Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLI P WALLACE MD (NPI 1518939867) is an individual family medicine provider in Fort Dodge, Iowa, licensed in Iowa (33478) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelli P Wallace Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kelli Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fort Dodge, IA 50501
- Reassigned Medicare billing, Iowa enrollment
- 387 clinicians in this Medicare group
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 50501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
FORT DODGE, IA 50501
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 Kelli Wallace's NPI number?
The NPI number for Kelli Wallace is 1518939867. It was assigned to this individual provider in the NPPES registry on February 2, 2006.
Where is Kelli Wallace located?
Kelli Wallace practices at 800 Kenyon Rd, Fort Dodge, IA 50501. The listed phone number is (515) 574-6800.
What is Kelli Wallace's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kelli Wallace enrolled in Medicare?
Yes. Kelli Wallace is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kelli Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelli Wallace reassigns Medicare benefits to Trinity Regional Medical Center (Fort Dodge, IA). The 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 Kelli Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelli Wallace accept?
Health plans from Medica, Oscar Insurance Company and Wellmark Health Plan of Iowa, Inc. list Kelli 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 Kelli Wallace was last updated on December 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Kelli P Wallace, MD · NPI 1518939867
Family Medicine physician in Fort Dodge, Iowa. Individual provider, active in the CMS NPPES registry since February 2, 2006.
## Identity
- **NPI:** 1518939867 (Entity type: Individual)
- **Enumerated:** February 2, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 33478 (Iowa)
- **Sole proprietor:** No
## Practice location
- **Address:** 800 KENYON RD, Fort Dodge, IA 50501-5776
- **Phone:** (515) 574-6800
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Trinity Regional Medical Center (NPI 1073594156, Fort Dodge, IA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 22, 2016
- **Other identifiers:** Medicare UPIN G35571; Medicare PIN I6190 (IA)
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Source: [NPI Profile](https://npiprofile.com/npi/1518939867) · Data from the CMS NPPES public registry.