TRACY WALLACE MD - NPI 1720306558 - Pediatrics in Gonzales, LA

Q: What is Tracy Wallace's NPI number?

The NPI number for Tracy Wallace is 1720306558. It was assigned to this individual provider in the NPPES registry on May 4, 2010.

Q: What is Tracy Wallace's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Tracy Wallace was last updated on May 19, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Tracy Wallace Md NPPES

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

TRACY WALLACE MD (NPI 1720306558) is an individual pediatrics provider in Gonzales, Louisiana, licensed in Louisiana (204717) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720306558

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameTRACY WALLACECredential: MD

Location Address1937 S BURNSIDE AVEGonzales, LA 70737-4632

Mailing Address5959 S Sherwood Forest BlvdBaton Rouge, LA 70816-6038 · (225) 765-5727 · Fax (225) 765-9196

Phone(225) 765-5500

Fax(225) 644-9286

Sole ProprietorNo

Enumeration DateMay 4, 2010

Last NPPES UpdateMay 19, 2021

NPPES CertifiedMay 19, 2021

✔ NPI 1720306558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in LA · 204717

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1937 S BURNSIDE AVE, Gonzales, LA 70737

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Other Identifiers 1

Medicaid2103831LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of Louisiana, HMO Louisiana and more.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)

Tracy Wallace Md 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 70737 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

$83.60 typical visit price

range $53.43 – $164.73

Typical copayment $20.90 (range $13.35 – $41.18)

Most-billed visit code 99203

Established Patient

$95.09 typical visit price

range $16.64 – $133.62

Typical copayment $23.77 (range $4.16 – $33.40)

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 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAMMIE A HILLIARD MD

Pediatrics