BRIAN WALLACE (N.P.) – Primary Care Nurse Practitioner, NPI 1457561615
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
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Provider Addresses for BRIAN WALLACE (N.P.)
1910, Roseland Boulevard, Azalea Historic District, Tyler, Smith County, Texas, 75701, United States
TYLER, TX 757014246
Phone: (903) 533-0644
Fax: (903) 533-0441
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 3 Open Payments records for all available years, with a total value of $125.
Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.
Last reported payment date: 2024-06-17 • Largest payer in this snapshot: Acella Pharmaceuticals, LLC ($56).
Total Amount
$125
General + Research + Ownership
Payments
3
Total payment records
General Amount
$125
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Acella Pharmaceuticals, LLC | $56 |
| ABIOMED | $48 |
| Abbott Laboratories | $21 |
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: 2022-07-14
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 |
|---|---|---|---|---|
| I20220714000066 | I | Nurse Practitioner | CO | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 38 | 26 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 17 | 17 | $0 |
Insurance plans in this area (ZIP 75701)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | CO | |
| - | CA | |
| - | CO | |
| Physician Assistant | CO | |
| Hospitalist, Family Practice | CO | |
| - | CO | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | CO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CO | |
| - | CO | |
| - | CO |
Reviews
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