LAURIE WALLACE DO
NPI 1699716613
Emergency Medicine - Emergency Medical Services in Farmington Hills, MI
About Laurie Wallace Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAURIE WALLACE DO (NPI 1699716613) is an individual emergency medical services provider in Farmington Hills, Michigan, licensed in Michigan (LW010385) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Laurie Wallace Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Laurie Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lansing, MI 48912
- Reassigned Medicare billing, Michigan enrollment
- Medicare enrollment name: Legacy Physician Group PC
- 9 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 4
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48336 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.
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.
FARMINGTON HILLS, MI 48336
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 Laurie Wallace's NPI number?
The NPI number for Laurie Wallace is 1699716613. It was assigned to this individual provider in the NPPES registry on June 9, 2006.
Where is Laurie Wallace located?
Laurie Wallace practices at 28050 Grand River Ave ER Department, Farmington Hills, MI 48336. The listed phone number is (248) 471-8000.
What is Laurie Wallace's specialty?
The primary specialty registered for this NPI is Emergency Medicine, specializing in Emergency Medical Services, with taxonomy code 207PE0004X.
Is Laurie Wallace enrolled in Medicare?
Yes. Laurie Wallace is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Laurie Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Laurie Wallace reassigns Medicare benefits to Legacy Physician Group, P.C. (Lansing, 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 Laurie 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 Laurie Wallace was last updated on November 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Laurie Wallace, DO · NPI 1699716613
Emergency Medical Services physician in Farmington Hills, Michigan. Individual provider, active in the CMS NPPES registry since June 9, 2006.
## Identity
- **NPI:** 1699716613 (Entity type: Individual)
- **Enumerated:** June 9, 2006
- **Primary specialty:** Emergency Medicine - Emergency Medical Services · taxonomy 207PE0004X
- **State license:** LW010385 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 28050 GRAND RIVER AVE, ER DEPARTMENT, Farmington Hills, MI 48336-5919
- **Phone:** (248) 471-8000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Legacy Physician Group, P.C. (NPI 1801800719, Lansing, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 28, 2016
- **Other identifiers:** Medicare ID-Type Unspecified N83060001 (MI); Medicaid 114570889 (MI); Medicare UPIN F07064
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Source: [NPI Profile](https://npiprofile.com/npi/1699716613) · Data from the CMS NPPES public registry.