DR. ELISE F WALLACE (MD) – Obstetrics & Gynecology Physician, NPI 1538140835

DR. ELISE F WALLACE (MD) is a healthcare provider. based in Rochester hills, Michigan. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. 4301077878 (MI). The NPI Number for DR. ELISE F WALLACE (MD) is 1538140835

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
DR. ELISE F WALLACE (MD)
NPI
1538140835
Phone
(248) 997-5805
Address
1701 SOUTH BLVD E
Enumeration Date
14 November 2005
Last Update Date
23 October 2020

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2482184073
Graduation Year
2001 (25 years ago)
PAC ID
6406887959
Group Practice PAC ID
4183673015
Professional Enrollment ID
I20050825000077
Address ID
MI480986334TR4550XDRXX341

Contacts

Secure Messaging
ewallace11805@direct.beaumont.edu
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

1,735 OBSTETRICS/GYNECOLOGY in MI

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Provider Addresses for DR. ELISE F WALLACE (MD)

  • East South Boulevard, Brooklands, Rochester Hills, Oakland County, Michigan, 48085, United States

    SUITE 200

    ROCHESTER HILLS, MI 483076122

    Phone: (248) 997-5805

    Fax: (248) 997-5811

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $84.

Total Amount is formed as General ($84) + Research ($0) + Ownership ($0) = $84.

Last reported payment date: 2024-09-26 • Largest payer in this snapshot: Sage Therapeutics, Inc. ($27).

Total Amount

$84

General + Research + Ownership

Payments

4

Total payment records

General Amount

$84

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-26

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2005-08-25

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
I20050825000077IObstetrics/GynecologyMITBD

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
99214Established patient office or other outpatient visit, 30-39 minutes10578$0
G0101Cervical or vaginal cancer screening; pelvic and clinical breast examination4747$0
76830Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina2218$0
99213Established patient office or other outpatient visit, 20-29 minutes2222$0
View full utilization report →

Insurance plans in this area (ZIP 48307)

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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: 4183673015View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMI
O B S T E T R I C S/ G Y N E C O L O G YMI
O B S T E T R I C S/ G Y N E C O L O G YMI
O B S T E T R I C S/ G Y N E C O L O G YMI
O B S T E T R I C S/ G Y N E C O L O G YMI
O B S T E T R I C S/ G Y N E C O L O G YMI
O B S T E T R I C S/ G Y N E C O L O G YCO
O B S T E T R I C S/ G Y N E C O L O G YMI
O B S T E T R I C S/ G Y N E C O L O G YMI
O B S T E T R I C S/ G Y N E C O L O G YMI

Reviews

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Frequently asked questions

Can I use this page to confirm DR. ELISE F WALLACE (MD)'s NPI?
Yes. DR. ELISE F WALLACE (MD) is listed with NPI 1538140835 in the public NPI dataset.
Is DR. ELISE F WALLACE (MD) listed as active for patients and plans?
The listing shows DR. ELISE F WALLACE (MD) as active in the NPI system.
What is DR. ELISE F WALLACE (MD)'s primary classification?
Obstetrics & Gynecology Physician is the headline specialty for DR. ELISE F WALLACE (MD) here. Clinical services aligned with this taxonomy classification.
What area does DR. ELISE F WALLACE (MD) serve?
DR. ELISE F WALLACE (MD)'s listing highlights Rochester Hills, Michigan; more addresses can appear in NPPES.
Is the information about DR. ELISE F WALLACE (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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