MRS. CYNTHIA WALLACE AGPCNP
NPI 1811393648
Nurse Practitioner - Gerontology in Medford, OR
About Mrs. Cynthia Wallace Agpcnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. CYNTHIA WALLACE AGPCNP (NPI 1811393648) is an individual gerontology provider in Medford, Oregon, licensed in Oregon (201500016NP-PP) and active in the NPI registry since November 2014. She is enrolled in Medicare PECOS, is affiliated with Providence Medford Medical Center, and is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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
Mrs. Cynthia Wallace Agpcnp 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.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Providence Medford Medical Center
Acute Care Hospitals · Medford, ORPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97504 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
MEDFORD, OR 97504
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 Cynthia Wallace's NPI number?
The NPI number for Cynthia Wallace is 1811393648. It was assigned to this individual provider in the NPPES registry on November 5, 2014.
Where is Cynthia Wallace located?
Cynthia Wallace practices at 1111 Crater Lake Ave, Medford, OR 97504. The listed phone number is (541) 732-5250.
What is Cynthia Wallace's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Cynthia Wallace enrolled in Medicare?
Yes. Cynthia 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.
What insurance does Cynthia Wallace accept?
Health plans from Providence Health Plan list Cynthia Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Cynthia Wallace affiliated with any hospitals?
According to CMS data, Cynthia Wallace is affiliated with Providence Medford Medical Center.
When was this NPI record last updated?
The NPPES record for Cynthia Wallace was last updated on September 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Mrs. Cynthia Wallace, AGPCNP · NPI 1811393648
Gerontology physician in Medford, Oregon. Individual provider, active in the CMS NPPES registry since November 5, 2014.
## Identity
- **NPI:** 1811393648 (Entity type: Individual)
- **Enumerated:** November 5, 2014
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 201500016NP-PP (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 1111 CRATER LAKE AVE, Medford, OR 97504-6241
- **Phone:** (541) 732-5250 · **Fax:** (541) 732-5251
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** September 30, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1811393648) · Data from the CMS NPPES public registry.