LEWIS ALFRED WALLACE (DO) – Internal Medicine Physician, NPI 1942292271

LEWIS ALFRED WALLACE (DO) is a healthcare provider. based in Ada, Oklahoma. specializing in INTERNAL MEDICINE. They hold the professional credentials DO. They hold a License No. 3060 (OK). The NPI Number for LEWIS ALFRED WALLACE (DO) is 1942292271

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
LEWIS ALFRED WALLACE (DO)
NPI
1942292271
Phone
(580) 421-4570
Address
1921 STONECIPHER BLVD
Enumeration Date
23 August 2005
Last Update Date
14 September 2016

Doctor Profile

Medical School Name
OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
5804363980
Graduation Year
1991 (35 years ago)
PAC ID
8921100322
Group Practice PAC ID
8426957523
Professional Enrollment ID
I20130208000391
Address ID
OK748203439AD1921XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,474 INTERNAL MEDICINE in OK

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Provider Addresses for LEWIS ALFRED WALLACE (DO)

  • Chickasaw Nation Medical Center, 1921, Stonecipher Boulevard, Ada, Pontotoc County, Oklahoma, 74820, United States

    ADA, OK 74820

    Phone: (580) 421-4570

    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)

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: 2013-02-08

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
I20130208000391IInternal MedicineTXTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes4139$0
99214Established patient office or other outpatient visit, 30-39 minutes2221$0
93227Electrocardiogram (ecg) 2-day continuous with review by health care professional1919$0
View full utilization report →

Insurance plans in this area (ZIP 74820)

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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: 8426957523View full group profile

Reviews

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Frequently asked questions

How do payers reference LEWIS ALFRED WALLACE (DO)?
For LEWIS ALFRED WALLACE (DO), use NPI 1942292271 as the unique 10-digit identifier.
Is there an active status for LEWIS ALFRED WALLACE (DO)?
For scheduling context, LEWIS ALFRED WALLACE (DO) is shown as active in the registry.
What clinical focus is listed for LEWIS ALFRED WALLACE (DO)?
At a glance, LEWIS ALFRED WALLACE (DO) is tied to Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Oklahoma is LEWIS ALFRED WALLACE (DO) registered?
Use Ada, Oklahoma as the headline location for LEWIS ALFRED WALLACE (DO) here.
Can I trust this NPI listing for LEWIS ALFRED WALLACE (DO)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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