KATHLEEN WALLACE (APN) – Nurse Practitioner, NPI 1225035504
Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
8,191 NURSE PRACTITIONER in IN
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Provider Addresses for KATHLEEN WALLACE (APN)
Oak Park, Huntsville, Madison County, Alabama, 35801-3609, United States
OAK PARK, IL 603024420
Phone: (708) 492-4531
Fax: (708) 763-0970
Type: Mailing
8668, Broadway, Merrillville, Lake County, Indiana, 46410, United States
MERRILLVILLE, IN 464107034
Phone: (219) 791-1556
Fax: (219) 791-1560
Type: Location
120 W 22ND ST STE 200
OAK BROOK, IL 605231563
Phone: (630) 573-5000
Fax: (630) 491-5472
Type: Mailing
90 W 86TH AVE
MERRILLVILLE, IN 464107086
Phone: (219) 791-1555
Fax: (219) 791-1560
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 72 Open Payments records for all available years, with a total value of $1,477.
Total Amount is formed as General ($1,477) + Research ($0) + Ownership ($0) = $1,477.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($186).
Total Amount
$1,477
General + Research + Ownership
Payments
72
Total payment records
General Amount
$1,477
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2013-02-01
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 |
|---|---|---|---|---|
| I20130201000460 | I | Nurse Practitioner | IN | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 190 | 131 | $0 |
| 90970 | Dialysis services, per day, less than full month service (20 years or older) | 85 | 17 | $0 |
| 90961 | Dialysis services, 2-3 physician visits per month (20 years or older) | 19 | 18 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 13 | 13 | $0 |
| 90960 | Dialysis services, 4 or more physician visits per month (20 years or older) | 11 | 11 | $0 |
Insurance plans in this area (ZIP 60302)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | IN | 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 53 | 29 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| N E P H R O L O G Y | IL | |
| Nephrology, Internal Medicine | IL | |
| Nurse Practitioner | IN | |
| N E P H R O L O G Y | IL | |
| - | IN | |
| N E P H R O L O G Y | IL | |
| N E P H R O L O G Y | IN | |
| N E P H R O L O G Y | IL | |
| - | IN | |
| N E P H R O L O G Y | IL |
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