Hannah Wallace, MD, MPH

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0101266944 Issued in VA

Practice address

UCLA Emergency Medicine
924 Westwood Blvd, Suite 300
Los Angeles, CA 90095-0001

Phone

(310) 794-0585

NPI assigned

Apr 9, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, FL2 enrollments

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 2

Specialty

Emergency Medicine

Education

University of Miami, LM Miller School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guidewell Emergency Medicine Doctors, LLCGroup PAC ID 8224352919, 88 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Guidewell Emergency Medicine Doctors, LLC

  • Urgent Care Clinic/Center
  • Winter Park, FL
  • NPI 1629497235
  Medicare reassignment Care Compare group NPD
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  Emergency Medicine, VA

  Medicare reassignment NPD
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment NPD
• Guidewell Emergency Medicine Doctors, LLC

  • Radiology Clinic/Center
  • Winter Park, FL
  • NPI 1639973555
  NPD
• Quality Primary Care P a

  • Primary Care Clinic/Center
  • Jacksonville, FL
  • NPI 1245525518
  NPD (past)

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1447646161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N HAYWORTH AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900482303",
            "telephone_number": "727-698-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCLA EMERGENCY MEDICINE",
            "address_2": "924 WESTWOOD BLVD, SUITE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-794-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "HANNAH",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101266944",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "MD82212",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME140712",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A148631",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• De Voria Wallace
• Debra Ann Wallace, FNP
• Dejuanna Wallace
• Emma Wallace
• Gunseli Wallace
• Jamaal Aqeel Wallace
• Jodee An Wallace
• Josephine Parrott Wallace, MFTI
• Juliana Wallace
• Karen Elyse Wallace, LCSW

• Emergency Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; 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.