STEPHANIE WALLACE (APRN CNP) – Family Nurse Practitioner, NPI 1194416792
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
14,984 NURSE PRACTITIONER in OH
Provider Addresses for STEPHANIE WALLACE (APRN CNP)
4807 ROCKSIDE RD STE 100
INDEPENDENCE, OH 441312188
Phone:
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 52 Open Payments records for all available years, with a total value of $1,272.
Total Amount is formed as General ($1,272) + Research ($0) + Ownership ($0) = $1,272.
Last reported payment date: 2024-11-22 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($612).
Total Amount
$1,272
General + Research + Ownership
Payments
52
Total payment records
General Amount
$1,272
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $612 |
| GENZYME CORPORATION | $291 |
| Journey Medical Corporation | $123 |
| Amgen Inc. | $109 |
| Incyte Corporation | $85 |
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: 2023-06-20
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 |
|---|---|---|---|---|
| I20230620002452 | I | Nurse Practitioner | OH | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 225 | 35 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 62 | 54 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 61 | 52 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 49 | 45 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 46 | 44 | $0 |
Insurance plans in this area (ZIP 44131)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | OH | |
| D E R M A T O L O G Y | OH | |
| D E R M A T O L O G Y | OH | |
| D E R M A T O L O G Y | OH | |
| D E R M A T O L O G Y | OH |
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