AMBER MICHELLE WALLACE NP
NPI 1679716534
Nurse Practitioner - Neonatal in South Bend, IN

Q: What is Amber Wallace's NPI number?

The NPI number for Amber Wallace is 1679716534. It was assigned to this individual provider in the NPPES registry on April 8, 2009.

Q: What is Amber Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, with taxonomy code 363LN0000X.

Q: When was this NPI record last updated?

The NPPES record for Amber Wallace was last updated on April 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since April 08, 2009PECOS Enrolled

615 N MICHIGAN ST 1ST FL HOSPITALIST STE, SOUTH BEND, IN 46601(574) 647-3050(574) 647-1094 Get Directions Write a Review

NPPES record last updated: April 28, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 6, 2021, Mar 30, 2021 (2 updates tracked since 2021).

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About Amber Michelle Wallace Np NPPES

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

AMBER MICHELLE WALLACE NP (NPI 1679716534) is an individual neonatal provider in South Bend, Indiana, licensed in Indiana (71002921A) and active in the NPI registry since April 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679716534

Entity TypeIndividualFemale

Primary Taxonomy363LN0000X

Provider Legal NameAMBER MICHELLE WALLACECredential: NP

Location Address615 N MICHIGAN ST 1ST FL HOSPITALIST STESouth Bend, IN 46601-1033

Mailing Address3245 Health Dr Ste 100Granger, IN 46530-1380

Phone(574) 647-3050

Fax(574) 647-1094

Sole ProprietorNo

Enumeration DateApril 8, 2009

Last NPPES UpdateApril 28, 20232 updates tracked since enumeration

NPPES CertifiedApril 28, 2023

✔ NPI 1679716534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · NeonatalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LN0000X

License✔ Licensed in IN · 71002921A

615 N MICHIGAN ST 1ST FL HOSPITALIST STE, South Bend, IN 46601

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Other Identifiers 1

Medicaid201017740IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amber Michelle Wallace Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46601 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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.

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.

NYCOLE WELLS MD

Internal Medicine