IMELDA V WALLACE (FNP-BC) – Family Nurse Practitioner, NPI 1003541095
Family Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for IMELDA V WALLACE (FNP-BC)
11860 VISTA DEL SOL DR STE 150
EL PASO, TX 799366128
Phone: (915) 808-4000
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 59 Open Payments records for all available years, with a total value of $1,764.
Total Amount is formed as General ($1,764) + Research ($0) + Ownership ($0) = $1,764.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Axonics, Inc. ($957).
Total Amount
$1,764
General + Research + Ownership
Payments
59
Total payment records
General Amount
$1,764
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Axonics, Inc. | $957 |
| Myriad Genetic Laboratories, Inc. | $169 |
| Progenics Pharmaceuticals, Inc. | $146 |
| 180 Medical, Inc. | $125 |
| Sumitomo Pharma America, Inc. | $61 |
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: 2023-07-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230725000497 | I | Nurse Practitioner | NM | 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 |
|---|---|---|---|---|
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 520 | 31 | $0 |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 67 | 62 | $0 |
| 81002 | Urinalysis, manual test | 60 | 56 | $0 |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 40 | 31 | $0 |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 40 | 31 | $0 |
Insurance plans in this area (ZIP 79936)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | TX | |
| - | TX | |
| Radiation Oncology | TX | |
| - | TX | |
| U R O L O G Y | TX | |
| U R O L O G Y | TX | |
| Diagnostic Radiology | NH | |
| Nurse Practitioner | NM | |
| U R O L O G Y | TX | |
| U R O L O G Y | TX |
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