DIANE E WALLACE (MD) – Emergency Medicine Physician, NPI 1194764647
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,266 EMERGENCY MEDICINE in IN
Loading map...
Provider Addresses for DIANE E WALLACE (MD)
608 UNION CHAPEL RD
FORT WAYNE, IN 468459357
Phone: (260) 498-2020
Fax: (260) 498-2030
Type: Mailing
Emergency Physicians Medical Group, 2000, Green Road, Ann Arbor, Washtenaw County, Michigan, 48105, United States
SUITE 300
ANN ARBOR, MI 481051598
Phone: (734) 995-3764
Type: Mailing
Franciscan ExpressCare Michigan City, 301, West Homer Street, Michigan City, LaPorte County, Indiana, 46360, United States
MICHIGAN CITY, IN 463604358
Phone: (219) 879-8511
Type: Location
1355 MARINERS DR
WARSAW, IN 465827145
Phone: (574) 372-0000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $63.
Total Amount is formed as General ($63) + Research ($0) + Ownership ($0) = $63.
Last reported payment date: 2024-10-22 • Largest payer in this snapshot: ABBVIE INC. ($63).
Total Amount
$63
General + Research + Ownership
Payments
2
Total payment records
General Amount
$63
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $63 |
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: 2007-03-01
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 |
|---|---|---|---|---|
| I20070301000195 | I | Emergency Medicine | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 74 | 68 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 40 | 40 | $0 |
Insurance plans in this area (ZIP 46845)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | NY | |
| Emergency Medicine | IN | |
| Emergency Medicine | WA | |
| Emergency Medicine | MO | |
| Emergency Medicine | MI | |
| Emergency Medicine | IN | |
| Emergency Medicine | OH | |
| Emergency Medicine | WI | |
| Family Practice, Emergency Medicine | KY | |
| Emergency Medicine | FL |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.