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DR. DANE C WALLACE NURSE PRACTITIONER
NPI 1528787744
Nurse Practitioner - Family in Edwardsville, IL

Active since August 22, 2022PECOS EnrolledAccepts Medicare Assignment
529 HILLSBORO AVE, EDWARDSVILLE, IL 62025(217) 621-8675 Get Directions Write a Review

NPPES record last updated: November 6, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 6, 2023, Aug 22, 2022 (2 updates tracked since 2022).

About Dr. Dane C Wallace Nurse Practitioner NPPES

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

DR. DANE C WALLACE NURSE PRACTITIONER (NPI 1528787744) is an individual family provider in Edwardsville, Illinois, licensed in Illinois (209.025563) and active in the NPI registry since August 2022. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1528787744
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameDR. DANE C WALLACECredential: NURSE PRACTITIONER
Location Address529 HILLSBORO AVEEdwardsville, IL 62025-1864
Mailing Address529 Hillsboro AveEdwardsville, IL 62025-1864 · (217) 621-8675
Phone(217) 621-8675
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateAugust 22, 2022
Last NPPES UpdateNovember 6, 20232 updates tracked since enumeration
NPPES CertifiedNovember 6, 2023
✔ NPI 1528787744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in IL · 209.025563✔ Licensed in MO · 2023036829
529 HILLSBORO AVE, Edwardsville, IL 62025
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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. Dane C Wallace Nurse Practitioner 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 ID7012393143
PECOS Enrollment IDI20220927003038
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 4

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
111 services108 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
64 services62 patients
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.
33 services33 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.
15 services15 patients

Hospital Affiliations CMS Care Compare 2

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

St Johns Hospital

Acute Care Hospitals · Springfield, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140053
Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County
Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140187
LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62025 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
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
Established Patient
$99.71 typical visit price
range $17.51 – $139.99
Typical copayment $24.92 (range $4.37 – $34.99)
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.

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 Dane Wallace's NPI number?

The NPI number for Dane Wallace is 1528787744. It was assigned to this individual provider in the NPPES registry on August 22, 2022.

Where is Dane Wallace located?

Dane Wallace practices at 529 Hillsboro Ave, Edwardsville, IL 62025. The listed phone number is (217) 621-8675.

What is Dane Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Dane Wallace enrolled in Medicare?

Yes. Dane 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.

Is Dane Wallace affiliated with any hospitals?

According to CMS data, Dane Wallace is affiliated with St Johns Hospital and Hshs St Elizabeth's Hospital.

When was this NPI record last updated?

The NPPES record for Dane Wallace was last updated on November 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.