AMINAH WALLACE NP
NPI 1790677912
Nurse Practitioner - Acute Care in Antioch, CA
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Aminah Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Colton, CA 92324
- Reassigned Medicare billing, California enrollment
- 27 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.
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.
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.
Which organization bills Medicare for Aminah Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Aminah Wallace reassigns Medicare benefits to Harbor Wound Care P.C. (Colton, CA). 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 Aminah 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 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 15 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.
# Aminah Wallace, NP · NPI 1790677912
Acute Care physician in Antioch, California. Individual provider, active in the CMS NPPES registry since July 21, 2025.
## Identity
- **NPI:** 1790677912 (Entity type: Individual)
- **Enumerated:** July 21, 2025
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** 95032514 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 2648 CARSON WAY, Antioch, CA 94531-8270
- **Phone:** (619) 534-5998
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Harbor Wound Care P.C. (NPI 1427922392, Colton, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** July 21, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1790677912) · Data from the CMS NPPES public registry.