AMANDA FRASER WALLACE (MD) – Pain Medicine (Anesthesiology) Physician, NPI 1174750707
Pain Medicine (Anesthesiology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,447 ANESTHESIOLOGY in IN
Provider Addresses for AMANDA FRASER WALLACE (MD)
888 S Auto Mall Rd
Bloomington, IN 474015430
Phone: (812) 353-2700
Fax: (812) 353-2701
Type: Location
755, Heritage Road, Golden, Jefferson County, Colorado, 80401, United States
GOLDEN, CO 804013600
Phone: (303) 277-0700
Type: Location
1818, East 7th Avenue, Denver, Colorado, 80218, United States
DENVER, CO 802183645
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $215.
Total Amount is formed as General ($215) + Research ($0) + Ownership ($0) = $215.
Last reported payment date: 2024-09-05 • Largest payer in this snapshot: Indivior Inc. ($84).
Total Amount
$215
General + Research + Ownership
Payments
12
Total payment records
General Amount
$215
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Indivior Inc. | $84 |
| Boston Scientific Corporation | $27 |
| Otsuka America Pharmaceutical, Inc. | $22 |
| ABBVIE INC. | $22 |
| PFIZER INC. | $17 |
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: 2019-01-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20131231000606 | I | Pain Management | CO | TBD |
| I20190125000077 | I | Anesthesiology | 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 |
|---|---|---|---|---|
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 44 | 23 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 40 | 23 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 29 | 29 | $0 |
| 99443 | Telephone medical discussion with physician, 21-30 minutes | 27 | 18 | $0 |
| 27096 | Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance | 19 | 12 | $0 |
Insurance plans in this area (ZIP 47401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CO | |
| Family Practice | CO | |
| - | CO | |
| Internal Medicine | CO | |
| Family Practice | FL | |
| Physician Assistant | CO | |
| N E U R O S U R G E R Y | CO | |
| - | OR | |
| Internal Medicine | CO | |
| Physical Therapist In Private Practice | CO |
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