Ellen Wallace, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A191094 Issued in CA

Practice address

500 San Pablo Ave
Albany, CA 94706-1103

Phone

(510) 204-8130

NPI assigned

Mar 25, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Massachusetts Medical School, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, Concord, CA, CCN 057004
• Ace Home Health Care & Hospice, Inc Home health agency, Orinda, CA, CCN 059461
• Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
• Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewallace669884@hisp.ehr.sutterhealth.org
• Direct secure messaging: ewallace603776@direct.ochin.org

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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Sutter East Bay Medical Foundation

  • Clinical Medical Laboratory
  • Berkeley, CA
  • NPI 1831381623
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ace Home Health Care & Hospice Inc

  • Home Health Agency
  • Orinda, CA
  • NPI 1437442878
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1295181477
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Berkeley, CA
  • NPI 1639523004
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  • Home Health Agency
  • Concord, CA
  • NPI 1083643944
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1427685734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 DUSTIN ST APT 1",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016046006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SAN PABLO AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947061103",
            "telephone_number": "510-204-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A191094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Adair Vernon, MFT
• Emily Cristina Viggiano, M.D.
• Laurie Vollen, MD
• Michael D Voyne, D.D.S.
• Sandra Waggener, D.C.
• Susan Wallace, L.AC.
• Andrew B Wallach, M.D.
• Amy Dian Walthall, PSY.D.
• Alex Wang, PH.D.
• Yi Wang, L.AC., DAOM

• Family Medicine Physician in Albany, CA
• Providers in Albany, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.

Verify at the official NPI Registry.