MARY WALLACE OTR
NPI 1689398141
Occupational Therapist in Saint Charles, MO
About Mary Wallace Otr NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY WALLACE OTR (NPI 1689398141) is an individual occupational therapist in Saint Charles, Missouri, licensed in Missouri (2022037104) and active in the NPI registry since September 2022. She is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
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
Mary Wallace Otr 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 Mary Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Saint Charles, MO 63301
- Reassigned Medicare billing, Missouri enrollment
- 30 clinicians in this Medicare group
Washington, MO 63090
- Reassigned Medicare billing, Missouri enrollment
- 73 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 5
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.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAINT CHARLES, MO 63301
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 Mary Wallace's NPI number?
The NPI number for Mary Wallace is 1689398141. It was assigned to this individual provider in the NPPES registry on September 28, 2022.
Where is Mary Wallace located?
Mary Wallace practices at 2150 W Randolph St, Saint Charles, MO 63301. The listed phone number is (636) 946-4966.
What is Mary Wallace's specialty?
The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.
Is Mary Wallace enrolled in Medicare?
Yes. Mary 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 Mary Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Wallace reassigns Medicare benefits to 2 organizations: Fox Rehabilitation Services Ot Mo LLC (Saint Charles, MO) and Legacy Healthcare Services Inc. (Washington, MO). 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 Mary Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mary Wallace was last updated on April 14, 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.