LEWIS ALFRED WALLACE DO
NPI 1942292271
Internal Medicine in Ada, OK

Active since August 23, 2005PECOS EnrolledAccepts Medicare Assignment
1921 STONECIPHER BLVD, ADA, OK 74820(580) 421-4570 Get Directions Write a Review

NPPES record last updated: September 14, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lewis Alfred Wallace Do NPPES

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

LEWIS ALFRED WALLACE DO (NPI 1942292271) is an individual internal medicine provider in Ada, Oklahoma, licensed in Oklahoma (3060) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Chickasaw Nation Medical Center, and is a graduate of Oklahoma State University College Of Osteopathic Medicine (1991).

NPPES Registry Identity

NPI1942292271
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameLEWIS ALFRED WALLACECredential: DO
Location Address1921 STONECIPHER BLVDAda, OK 74820
Mailing Address1921 Stonecipher BlvdAda, OK 74820 · (580) 421-4570
Sole ProprietorNo
Medical School CMSOklahoma State University College Of Osteopathic MedicineGraduated 1991
Enumeration DateAugust 23, 2005
Last NPPES UpdateSeptember 14, 2016
NPI 1942292271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in OK · 3060
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1921 STONECIPHER BLVD, Ada, OK 74820

Other Names 1

Other Name (5)Fred Wallace D.o.

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

Lewis Alfred Wallace Do 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 ID8921100322
PECOS Enrollment IDI20130208000391
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.

Areas of Expertise CMS Part B claims 2

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
18 services17 patients
Electrocardiogram (ecg) 2-day continuous with review by health care professional 93227
An Electrocardiogram (ECG) is a test that checks your heart's activity. The 2-day continuous ECG records your heart's rhythm non-stop for 48 hours. It helps to detect irregularities that may not occur during a shorter test. A healthcare professional will review the results to identify any issues.
14 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Chickasaw Nation Medical Center

Acute Care Hospitals · Ada, OK
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number370180
Location1921 Stonecipher BlvdAda, OK 74820 · Pontotoc County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74820 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
$123.06 typical visit price
range $53.00 – $162.61
Typical copayment $30.76 (range $13.25 – $40.65)
Most-billed visit code 99204
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
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.

Dentist
1921 STONECIPHER BLVD
ADA, OK 74820
Obstetrics & Gynecology
1921 STONECIPHER BLVD
ADA, OK 74820
Counselor (Mental Health)
1921 STONECIPHER BLVD
ADA, OK 74820
Dietitian, Registered
1921 STONECIPHER BLVD
ADA, OK 74820
Advanced Practice Midwife
1921 STONECIPHER BLVD
ADA, OK 74820
Surgery
1921 STONECIPHER BLVD
ADA, OK 74820
Physical Therapist
1921 STONECIPHER BLVD
ADA, OK 74820
Family Medicine
1921 STONECIPHER BLVD
ADA, OK 74820

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 Lewis Wallace's NPI number?

The NPI number for Lewis Wallace is 1942292271. It was assigned to this individual provider in the NPPES registry on August 23, 2005. The provider is also known as Fred Wallace D.O..

Where is Lewis Wallace located?

Lewis Wallace practices at 1921 Stonecipher Blvd, Ada, OK 74820. The listed phone number is (580) 421-4570.

What is Lewis Wallace's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Lewis Wallace enrolled in Medicare?

Yes. Lewis 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 Lewis Wallace accept?

Health plans from Blue Cross and Blue Shield of Oklahoma and UnitedHealthcare list Lewis 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 Lewis Wallace affiliated with any hospitals?

According to CMS data, Lewis Wallace is affiliated with Chickasaw Nation Medical Center.

When was this NPI record last updated?

The NPPES record for Lewis Wallace was last updated on September 14, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.