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MS. MICAH R WALLACE PA-C
NPI 1588946214
Physician Assistant - Surgical in Latrobe, PA

Active since September 20, 2011PECOS EnrolledAccepts Medicare Assignment
100 EXCELA HEALTH DR STE 102, LATROBE, PA 15650(724) 804-1760(724) 804-1762 Get Directions Write a Review

NPPES record last updated: December 21, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 21, 2018, Jan 19, 2017, Mar 29, 2016 (3 updates tracked since 2016).

About Ms. Micah R Wallace Pa-c NPPES

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

MS. MICAH R WALLACE PA-C (NPI 1588946214) is an individual surgical provider in Latrobe, Pennsylvania, licensed in Pennsylvania (MA054581) and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS, is affiliated with Excela Health Latrobe Hospital, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1588946214
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMS. MICAH R WALLACECredential: PA-C
Location Address100 EXCELA HEALTH DR STE 102Latrobe, PA 15650-9001
Mailing Address520 Jefferson Ave, Suite 400Jeannette, PA 15644-2538 · (724) 527-8060 · Fax (724) 522-4002
Phone(724) 804-1760
Fax(724) 804-1762
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateSeptember 20, 2011
Last NPPES UpdateDecember 21, 20183 updates tracked since enumeration
✔ NPI 1588946214 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in PA · MA054581
100 EXCELA HEALTH DR STE 102, Latrobe, PA 15650
Open in Google Maps ↗

Other Identifiers 1

Medicaid103167119PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Ms. Micah R Wallace Pa-c 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 ID7113188970
PECOS Enrollment IDI20120423000331
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 2

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 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.
90 services76 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.
63 services49 patients

Hospital Affiliations CMS Care Compare

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

Excela Health Latrobe Hospital

Acute Care Hospitals · Latrobe, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390219
LocationOne Mellon WayLatrobe, PA 15650 · Westmoreland County
Emergency services

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.

DR. RAHUL K NAIDU MD
Otolaryngology (Facial Plastic Surgery)
100 EXCELA HEALTH DR STE 102
LATROBE, PA 15650
Westmoreland County (724) 804-1760
MADELINE STARKEY AUD
Audiologist
100 EXCELA HEALTH DR STE 102
LATROBE, PA 15650
Westmoreland County (724) 804-1760

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 Micah Wallace's NPI number?

The NPI number for Micah Wallace is 1588946214. It was assigned to this individual provider in the NPPES registry on September 20, 2011.

Where is Micah Wallace located?

Micah Wallace practices at 100 Excela Health Dr Ste 102, Latrobe, PA 15650. The listed phone number is (724) 804-1760.

What is Micah Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Micah Wallace enrolled in Medicare?

Yes. Micah 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 Micah Wallace accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Micah 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 Micah Wallace affiliated with any hospitals?

According to CMS data, Micah Wallace is affiliated with Excela Health Latrobe Hospital.

When was this NPI record last updated?

The NPPES record for Micah Wallace was last updated on December 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.