Active NPI
Emily Wallace, PA-C
- Physician Assistant
- Belding, MI
National Provider Identifier
1326680331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1320 W State St Ste 3a
Belding, MI 48809-9245 - Phone
- (616) 794-1810
- NPI assigned
- Oct 10, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
1320 W State St Ste 3a
Belding, MI 48809-9245
Mailing address
1320 W State St Ste 3a
Belding, MI 48809-9245
Phone (616) 794-1810
Other names 1
- Emily Lazzar
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220706003224 | MI | Practitioner - Physician Assistant | 6800276049 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Charles R Barker Jr DO Family Practice PC
Practice addresses (Care Compare)
1320 W State St
Suite 3a
Belding, MI 48809-9245
Phone (616) 794-1810
Hospital & facility affiliations
- Spectrum Health United Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710288000000",
"number": "1326680331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 W STATE ST STE 3A",
"city": "BELDING",
"state": "MI",
"postal_code": "488099245",
"telephone_number": "616-794-1810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 W STATE ST STE 3A",
"city": "BELDING",
"state": "MI",
"postal_code": "488099245",
"telephone_number": "616-794-1810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "EMILY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-10",
"last_updated": "2024-03-13",
"certification_date": "2024-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "LAZZAR",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Belding, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.