BETHANY ANN WALLACE DO
NPI 1740371699
Family Medicine in Colorado Springs, CO

Q: What is Bethany Wallace's NPI number?

The NPI number for Bethany Wallace is 1740371699. It was assigned to this individual provider in the NPPES registry on September 27, 2006.

Q: What is Bethany Wallace's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Bethany Wallace was last updated on May 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.

Active since September 27, 2006PECOS Enrolled

8890 N UNION BLVD STE 170, COLORADO SPRINGS, CO 80920(719) 365-6421(719) 365-6408 Get Directions Write a Review

NPPES record last updated: May 14, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Bethany Ann Wallace Do NPPES

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

BETHANY ANN WALLACE DO (NPI 1740371699) is an individual family medicine provider in Colorado Springs, Colorado, licensed in Colorado (27638) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740371699

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameBETHANY ANN WALLACECredential: DO

Location Address8890 N UNION BLVD STE 170Colorado Springs, CO 80920-2701

Mailing Address558 E Castle Pines Pkwy Pmb 151Castle Rock, CO 80108-4608 · (719) 365-6421 · Fax (710) 365-6408

Phone(719) 365-6421

Fax(719) 365-6408

Sole ProprietorYes

Enumeration DateSeptember 27, 2006

Last NPPES UpdateMay 14, 2023

NPPES CertifiedMay 14, 2023

✔ NPI 1740371699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CO · 27638

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

8890 N UNION BLVD STE 170, Colorado Springs, CO 80920

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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)

Bethany Ann Wallace Do 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 80920 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

$89.43 typical visit price

range $58.06 – $174.82

Typical copayment $22.35 (range $14.51 – $43.70)

Most-billed visit code 99203

Established Patient

$102.03 typical visit price

range $18.88 – $142.79

Typical copayment $25.50 (range $4.72 – $35.69)

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 15

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

MRS. BREANNA DANIELLE FREES PA-C

Physician Assistant