STEPHANIE MARY WALLACE MD
NPI 1639304736
Anesthesiology in Appleton, WI
About Stephanie Mary Wallace Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STEPHANIE MARY WALLACE MD (NPI 1639304736) is an individual anesthesiology provider in Appleton, Wisconsin, licensed in Wisconsin (60446) and active in the NPI registry since May 2009. She is enrolled in Medicare PECOS, is affiliated with Bellin Memorial Hospital, and is a graduate of Medical College Of Wisconsin (2009).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Stephanie Mary Wallace Md 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.
Medicare Billing Reassignments
7Medicare enrollment records show Stephanie Wallace reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Neenah, WI 54956
- Reassigned Medicare billing, Wisconsin enrollment
- 144 clinicians in this Medicare group
Green Bay, WI 54311
- Reassigned Medicare billing, Wisconsin enrollment
- 43 clinicians in this Medicare group
Green Bay, WI 54301
- Reassigned Medicare billing, Wisconsin enrollment
- 129 clinicians in this Medicare group
Green Bay, WI 54301
- Reassigned Medicare billing, Wisconsin enrollment
- Medicare enrollment name: Bellin Anesthesia Associates Sc
- 61 clinicians in this Medicare group
Fond Du Lac, WI 54935
- Reassigned Medicare billing, Wisconsin enrollment
- 606 clinicians in this Medicare group
Beloit, WI 53511
- Reassigned Medicare billing, Wisconsin enrollment
- 28 clinicians in this Medicare group
Geneva, IL 60134
- Reassigned Medicare billing, Wisconsin enrollment
- 33 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.
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Bellin Memorial Hospital
Acute Care Hospitals · Green Bay, WISt Vincent Hospital
Acute Care Hospitals · Green Bay, WISt. Agnes Hospital Hospice
Acute Care Hospitals · Fond Du Lac, WIWaupun Memorial Hospital
Critical Access Hospitals · Waupun, WIMedicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
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.
APPLETON, WI 54915
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 Stephanie Wallace's NPI number?
The NPI number for Stephanie Wallace is 1639304736. It was assigned to this individual provider in the NPPES registry on May 19, 2009. The provider is also known as Stephanie Mary Johnson.
Where is Stephanie Wallace located?
Stephanie Wallace practices at 1506 S Oneida St, Appleton, WI 54915. The listed phone number is (920) 738-2611.
What is Stephanie Wallace's specialty?
The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.
Is Stephanie Wallace enrolled in Medicare?
Yes. Stephanie 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.
Which organizations bill Medicare for Stephanie Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stephanie Wallace reassigns Medicare benefits to 7 organizations: Association Of Hospital Anesthesiologists Sc (Neenah, WI), Osms Anesthesia LLC (Green Bay, WI), Green Bay Anesthesia Assoc. Sc (Green Bay, WI), Bellin Anesthesia Associates, S.C. (Green Bay, WI), Agnesian Healthcare Inc (Fond Du Lac, WI) and 2 more organizations, listed in the Medicare section above. Each 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 Stephanie Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Stephanie Wallace accept?
Health plans from CareSource (Common Ground Healthcare) list Stephanie 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 Stephanie Wallace affiliated with any hospitals?
According to CMS data, Stephanie Wallace is affiliated with Bellin Memorial Hospital, St Vincent Hospital, St. Agnes Hospital Hospice and Waupun Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Stephanie Wallace was last updated on October 26, 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.
# Stephanie Mary Wallace, MD · NPI 1639304736
Anesthesiology physician in Appleton, Wisconsin. Individual provider, active in the CMS NPPES registry since May 19, 2009.
## Identity
- **NPI:** 1639304736 (Entity type: Individual)
- **Enumerated:** May 19, 2009
- **Primary specialty:** Anesthesiology · taxonomy 207L00000X
- **State license:** 60446 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 1506 S ONEIDA ST, Appleton, WI 54915-1305
- **Phone:** (920) 738-2611
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 7 organizations under Medicare reassignment (form CMS-855R): Association Of Hospital Anesthesiologists Sc (NPI 1720076474, Neenah, WI); Osms Anesthesia LLC (NPI 1447017983, Green Bay, WI); Green Bay Anesthesia Assoc. Sc (NPI 1023065836, Green Bay, WI); Bellin Anesthesia Associates, S.C. (NPI 1558318410, Green Bay, WI); Agnesian Healthcare Inc (NPI 1730162991, Fond Du Lac, WI); and 2 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Medical College Of Wisconsin, class of 2009
## Record status
- **NPPES last updated:** October 26, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1639304736) · Data from the CMS NPPES public registry.