HAILY WALLACE MD
NPI 1679839534
Family Medicine in Tucumcari, NM
About Haily Wallace Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HAILY WALLACE MD (NPI 1679839534) is an individual family medicine provider in Tucumcari, New Mexico, licensed in New Mexico (MD2014-0895) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS, is affiliated with Plains Regional Medical Center, and is a graduate of University Of New Mexico School Of Medicine (2012).
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
Haily 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
2Medicare enrollment records show Haily Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Tucumcari, NM 88401
- Reassigned Medicare billing, New Mexico enrollment
- 153 clinicians in this Medicare group
Santa Rosa, NM 88435
- Reassigned Medicare billing, New Mexico enrollment
- 31 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.
Areas of Expertise CMS Part B claims 6
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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Plains Regional Medical Center
Acute Care Hospitals · Clovis, NMDr Dan C Trigg Memorial Hospital
Critical Access Hospitals · Tucumcari, NMBsa Hospital
Acute Care Hospitals · Amarillo, TXPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 88401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Referred Medical Equipment & Supplies CMS DME claims 20
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
TUCUMCARI, NM 88401
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 Haily Wallace's NPI number?
The NPI number for Haily Wallace is 1679839534. It was assigned to this individual provider in the NPPES registry on April 5, 2012. The provider is also known as Haily Catharine Lee-Wallace.
Where is Haily Wallace located?
Haily Wallace practices at 402 E Miel De Luna Ave Pmg At Dr Dan C Trigg Memorial Hospital, Tucumcari, NM 88401. The listed phone number is (575) 461-7100.
What is Haily Wallace's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Haily Wallace enrolled in Medicare?
Yes. Haily 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 Haily Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Haily Wallace reassigns Medicare benefits to 2 organizations: Presbyterian Healthcare Services (Tucumcari, NM) and Sunrise Clinics (Santa Rosa, NM). 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 Haily Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Haily Wallace accept?
Health plans from Blue Cross and Blue Shield of Texas list Haily 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 Haily Wallace affiliated with any hospitals?
According to CMS data, Haily Wallace is affiliated with Plains Regional Medical Center, Dr Dan C Trigg Memorial Hospital and Bsa Hospital.
When was this NPI record last updated?
The NPPES record for Haily Wallace was last updated on June 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Haily Wallace, MD · NPI 1679839534
Family Medicine physician in Tucumcari, New Mexico. Individual provider, active in the CMS NPPES registry since April 5, 2012.
## Identity
- **NPI:** 1679839534 (Entity type: Individual)
- **Enumerated:** April 5, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** MD2014-0895 (New Mexico)
- **Sole proprietor:** No
## Practice location
- **Address:** 402 E MIEL DE LUNA AVE, PMG AT DR DAN C TRIGG MEMORIAL HOSPITAL, Tucumcari, NM 88401-3828
- **Phone:** (575) 461-7100 · **Fax:** (575) 461-7101
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Presbyterian Healthcare Services (NPI 1962488304, Tucumcari, NM); Sunrise Clinics (NPI 1164055927, Santa Rosa, NM) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of New Mexico School Of Medicine, class of 2012
## Record status
- **NPPES last updated:** June 18, 2015
---
Source: [NPI Profile](https://npiprofile.com/npi/1679839534) · Data from the CMS NPPES public registry.