SHANE EDWARD WALLACE DC
NPI 1639753239
Chiropractor in Brooklyn, MI
About Shane Edward Wallace Dc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHANE EDWARD WALLACE DC (NPI 1639753239) is an individual chiropractor in Brooklyn, Michigan, licensed in Michigan (2301011096) and active in the NPI registry since May 2021. He is a graduate of Life Chiropractic College (2019).
NPPES Registry Identity
Specialties & Licenses
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
Shane Edward Wallace Dc 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 Reassignment
Medicare enrollment records show Shane Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Tecumseh, MI 49286
- Reassigned Medicare billing, Michigan enrollment
- 2 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.
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.
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 Shane Wallace's NPI number?
The NPI number for Shane Wallace is 1639753239. It was assigned to this individual provider in the NPPES registry on May 10, 2021.
Where is Shane Wallace located?
Shane Wallace practices at 9909 Wamplers Lake Rd, Brooklyn, MI 49230. The listed phone number is (517) 592-8208.
What is Shane Wallace's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Shane Wallace enrolled in Medicare?
Yes. Shane 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 organization bills Medicare for Shane Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shane Wallace reassigns Medicare benefits to Tribe Chiropractic PLLC (Tecumseh, MI). 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 Shane Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Shane Wallace accept?
Health plans from Priority Health list Shane 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 Shane Wallace was last updated on May 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Shane Edward Wallace, DC · NPI 1639753239
Chiropractor provider in Brooklyn, Michigan. Individual provider, active in the CMS NPPES registry since May 10, 2021.
## Identity
- **NPI:** 1639753239 (Entity type: Individual)
- **Enumerated:** May 10, 2021
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **State license:** 2301011096 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 9909 WAMPLERS LAKE RD, Brooklyn, MI 49230-9503
- **Phone:** (517) 592-8208
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Tribe Chiropractic PLLC (NPI 1134988652, Tecumseh, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Life Chiropractic College, class of 2019
## Record status
- **NPPES last updated:** May 10, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1639753239) · Data from the CMS NPPES public registry.