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STEPHANIE MARY WALLACE MD
NPI 1639304736
Anesthesiology in Appleton, WI

Active since May 19, 2009PECOS EnrolledAccepts Medicare Assignment
1506 S ONEIDA ST, APPLETON, WI 54915(920) 738-2611 Get Directions Write a Review

NPPES record last updated: October 26, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Oct 26, 2023, Dec 22, 2015 (2 updates tracked since 2015).

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

NPI1639304736
Entity TypeIndividualFemale
Primary Taxonomy207L00000X
Provider Legal NameSTEPHANIE MARY WALLACECredential: MD
Location Address1506 S ONEIDA STAppleton, WI 54915-1305
Mailing Address1506 S Oneida StAppleton, WI 54915-1305 · (920) 738-2611
Phone(920) 738-2611
Sole ProprietorNo
Medical School CMSMedical College Of WisconsinGraduated 2009
Enumeration DateMay 19, 2009
Last NPPES UpdateOctober 26, 20232 updates tracked since enumeration
NPPES CertifiedOctober 26, 2023
✔ NPI 1639304736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in WI · 60446
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1506 S ONEIDA ST, Appleton, WI 54915
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Other Names 1

Former Name (1)Stephanie Mary Johnson

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare), Medica.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

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.

PECOS PAC ID446492995
PECOS Enrollment IDI20130812000820
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.

Hospital Affiliations CMS Care Compare 3

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

Bellin Memorial Hospital

Acute Care Hospitals · Green Bay, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520049
Location744 S Webster AveGreen Bay, WI 54305 · Brown County
Emergency services Birthing friendly

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown County
Emergency services Birthing friendly

St. Agnes Hospital Hospice

Acute Care Hospitals · Fond Du Lac, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520088
Location430 E Division StFond Du Lac, WI 54935 · Fond Du Lac County
Emergency services Birthing friendly

Medicare 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

Pre-operative OSA assessment
Percentage of patients who undergo a surgical procedure in the operating room/procedure room that have a pre-operative assessment for Obstructive Sleep Apnea (OSA)
100%457 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

FOX VALLEY NEONATOLOGY SC
Pediatrics (Neonatal-Perinatal Medicine)
1506 S ONEIDA ST
APPLETON, WI 54915
Calumet County (920) 738-2000
ANNA QUELLA RD, LD, MS
Dietitian, Registered
1506 S ONEIDA ST
APPLETON, WI 54915
Calumet County (920) 831-1602
ASCENSION NE WISCONSIN, INC
Skilled Nursing Facility
1506 S ONEIDA ST
APPLETON, WI 54915
Calumet County (920) 720-1464
KAYLA MARIE LETTERMAN DPT
Physical Therapist
1506 S ONEIDA ST
APPLETON, WI 54915
Calumet County (920) 738-2681
BESSANT A PARKER MD
Hospitalist
1506 S ONEIDA ST, HOSPITAL SERVICE DEPARTMENT
APPLETON, WI 54915
Calumet County (920) 738-2000
DR. JOSEPH DOMINIC CHABOT D.O.
Neurological Surgery
1506 S ONEIDA ST
APPLETON, WI 54915
Calumet County (920) 738-2000
PANKAJ JAIN
Pediatrics (Neonatal-Perinatal Medicine)
1506 S ONEIDA ST
APPLETON, WI 54915
Calumet County (920) 730-7670
SAMUEL A. SOUTHARD CRNA
Nurse Anesthetist, Certified Registered
1506 S ONEIDA ST
APPLETON, WI 54915
Calumet County (920) 738-2000

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.

What insurance does Stephanie Wallace accept?

Health plans from CareSource (Common Ground Healthcare) and Medica 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 and St. Agnes Hospital Hospice.

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.