AMY ANN WALLACE (OTR-L) – Occupational Therapist, NPI 1467517466
Occupational Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,224 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in CA
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Provider Addresses for AMY ANN WALLACE (OTR-L)
South Lake Tahoe, El Dorado County, California, United States
SOUTH LAKE TAHOE, CA 961507026
Phone: (530) 543-5896
Fax: (530) 544-6512
Type: Location
2170 South Ave
South Lake Tahoe, CA 961507026
Phone: (530) 543-5896
Fax: (530) 544-6512
Type: Location
1139 3rd St
South Lake Tahoe, CA 961503465
Phone: (530) 543-5706
Fax: (530) 541-4130
Type: Location
1749 N Stewart St Ste 50
Carson City, NV 897062574
Phone: (775) 348-8800
Fax: (833) 687-1419
Type: Location
780 Vista Blvd Ste 100
Sparks, NV 894346677
Phone: (775) 348-8800
Fax: (833) 687-1419
Type: Location
935 Mica Dr Ste 13
Carson City, NV 897057181
Phone: (775) 783-3065
Fax: (775) 267-1829
Type: Location
155 Highway 50 Fl 2
Stateline, NV 894499816
Phone: (775) 589-8953
Fax: (775) 589-8920
Type: Location
10539 PROFESSIONAL CIR
SUITE 201
SOUTH LAKE TAHOE, CA 961503828
Phone: (775) 348-8800
Fax: (833) 687-1419
Type: Location
PO BOX 9578
SOUTH LAKE TAHOE, CA 96158
Phone: (530) 543-5896
Fax: (530) 544-6512
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-12-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20181218001251 | I | Occupational Therapist In Private Practice | NV | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 96150)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Occupational Therapist In Private Practice | CA | |
| Occupational Therapist In Private Practice | CA | |
| Critical Care (Intensivists), Emergency Medicine | NV | |
| Family Practice | CA | |
| Family Practice | CA | |
| P S Y C H I A T R Y | CA | |
| Critical Care (Intensivists), Emergency Medicine, Emergency Medicine | CA | |
| O T O L A R Y N G O L O G Y | PA | |
| U R O L O G Y | CA | |
| Internal Medicine | CA |
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