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AMINAH WALLACE NP
NPI 1790677912
Nurse Practitioner - Acute Care in Antioch, CA

Active since July 21, 2025PECOS EnrolledAccepts Medicare Assignment
2648 CARSON WAY, ANTIOCH, CA 94531(619) 534-5998 Get Directions Write a Review

NPPES record last updated: July 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Aminah Wallace Np NPPES

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

AMINAH WALLACE NP (NPI 1790677912) is an individual acute care provider in Antioch, California, licensed in California (95032514) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1790677912
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameAMINAH WALLACECredential: NP
Location Address2648 CARSON WAYAntioch, CA 94531-8270
Mailing Address2648 Carson WayAntioch, CA 94531-8270 · (619) 534-5998
Phone(619) 534-5998
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJuly 21, 2025
NPPES CertifiedJuly 21, 2025
✔ NPI 1790677912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in CA · 95032514
2648 CARSON WAY, Antioch, CA 94531
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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 and accepts Medicare assignment

Aminah Wallace Np 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.

PECOS PAC ID7012483373
PECOS Enrollment IDI20260415002234
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 94531 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.

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 Aminah Wallace's NPI number?

The NPI number for Aminah Wallace is 1790677912. It was assigned to this individual provider in the NPPES registry on July 21, 2025.

Where is Aminah Wallace located?

Aminah Wallace practices at 2648 Carson Way, Antioch, CA 94531. The listed phone number is (619) 534-5998.

What is Aminah Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Aminah Wallace enrolled in Medicare?

Yes. Aminah 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.

When was this NPI record last updated?

The NPPES record for Aminah Wallace was last updated on July 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.