ROBERT WALLACE PA, NP
NPI 1720315336
Nurse Practitioner - Family in Oakland, CA

Q: What is Robert Wallace's NPI number?

The NPI number for Robert Wallace is 1720315336. It was assigned to this individual provider in the NPPES registry on November 3, 2009.

Q: What is Robert Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Robert Wallace was last updated on June 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 November 03, 2009PECOS Enrolled

747 52ND ST, OAKLAND, CA 94609(510) 428-3022(510) 428-3022 Get Directions Write a Review

NPPES record last updated: June 11, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Robert Wallace Pa, Np NPPES

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

ROBERT WALLACE PA, NP (NPI 1720315336) is an individual family provider in Oakland, California, licensed in California (19738) and active in the NPI registry since November 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720315336

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameROBERT WALLACECredential: PA, NP

Location Address747 52ND STOakland, CA 94609-1809

Mailing Address747 52nd StOakland, CA 94609-1809 · (510) 238-0121 · Fax (510) 238-0121

Phone(510) 428-3022

Fax(510) 428-3022

Sole ProprietorNo

Enumeration DateNovember 3, 2009

Last NPPES UpdateJune 11, 2012

✔ NPI 1720315336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363LF0000X

License✔ Licensed in CA · 19738

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA20650 (CA)

747 52ND ST, Oakland, CA 94609

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Robert Wallace Pa, 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 94609 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

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

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.

MRS. SHERYL LEE GARCIA RN

Registered Nurse (Pediatrics)

747 52ND ST
OAKLAND, CA 94609

Alameda County (510) 428-3885

ERICA TRINGALE N.P,

Nurse Practitioner (Pediatrics)

747 52ND ST
OAKLAND, CA 94609

Alameda County (510) 428-3373

MRS. NATALIE PLOTKIN MS, ACPNP

Pediatrics (Pediatric Hematology-Oncology)

747 52ND ST
OAKLAND, CA 94609

Alameda County (510) 428-3484

REBECCA ROMANOV MD

Pediatrics

747 52ND ST
OAKLAND, CA 94609

Alameda County (510) 428-3331

SHELLEY ANNE BULL CPNP-PC

Nurse Practitioner (Pediatrics)

747 52ND ST
OAKLAND, CA 94609

Alameda County (510) 428-3885

KARIDA ADETORO

Student in an Organized Health Care Education/Training Program

747 52ND ST
OAKLAND, CA 94609

Alameda County (510) 428-3885

ANNIE ROQUE

Nurse Practitioner (Pediatrics)

747 52ND ST
OAKLAND, CA 94609

Alameda County (510) 428-4418

CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND

General Acute Care Hospital

747 52ND ST
OAKLAND, CA 94609

Alameda County (510) 428-3885

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 Robert Wallace's NPI number?

The NPI number for Robert Wallace is 1720315336. It was assigned to this individual provider in the NPPES registry on November 3, 2009.

Where is Robert Wallace located?

Robert Wallace practices at 747 52nd St, Oakland, CA 94609. The listed phone number is (510) 428-3022.

What is Robert Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Robert Wallace enrolled in Medicare?

Yes. Robert Wallace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Robert Wallace was last updated on June 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.