AMY WALLACE (DO) – Emergency Medicine Physician, NPI 1134619463

AMY WALLACE (DO) is a healthcare provider. based in Highland, Michigan. specializing in EMERGENCY MEDICINE. They hold the professional credentials DO. They hold a License No. 1134619463 (MI). The NPI Number for AMY WALLACE (DO) is 1134619463

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
AMY WALLACE (DO)
NPI
1134619463
Phone
Not provided
Address
1488 SCHOONER CV
Enumeration Date
11 May 2018
Last Update Date
30 June 2022

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
2484718000
Graduation Year
2018 (8 years ago)
PAC ID
7618232083
Group Practice PAC ID
6305732140
Professional Enrollment ID
I20220510001702
Address ID
MI483365919FA28050AVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:8State licenses:2Digital endpointsOther names

3,158 EMERGENCY MEDICINE in MI

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Provider Addresses for AMY WALLACE (DO)

  • 1488 SCHOONER CV

    HIGHLAND, MI 483562259

    Phone:

    Type: Mailing

  • 660 MILFORD FARMS CT

    MILFORD, MI 483813351

    Phone:

    Type: Mailing

  • Beaumont Hospital - Farmington Hills, 28050, Grand River Avenue, Farmington Hills, Oakland County, Michigan, 48336, United States

    FARMINGTON HILLS, MI 483365919

    Phone: (248) 471-8822

    Type: Location

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: 2022-05-10

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220510001702IEmergency MedicineMITBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making138138$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only130123$0
99284Emergency department visit with moderate level of medical decision making4847$0
99291Critical care, first 30-74 minutes4040$0
View full utilization report →

Insurance plans in this area (ZIP 48356)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305732140View full group profile
NameSpecialtyState
Emergency MedicineOH
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI

Reviews

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Frequently asked questions

What number should I use to identify AMY WALLACE (DO) for billing?
Administrative and clinical systems typically use NPI 1134619463 for AMY WALLACE (DO).
Is AMY WALLACE (DO)'s NPI status active today?
Active status means AMY WALLACE (DO)'s NPI record is not deactivated in the public file.
What services align with AMY WALLACE (DO)'s listing?
AMY WALLACE (DO)'s public classification highlights Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to AMY WALLACE (DO)?
AMY WALLACE (DO) shows a connection to Highland, Michigan in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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