Amy Ann Wallace, OTR-L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0721 Issued in NV

Practice address

10539 Professional Cir
Suite 201
South Lake Tahoe, CA 96150-3828

Phone

(775) 348-8800

Fax

(833) 687-1419

NPI assigned

Dec 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barton Medical FoundationGroup PAC ID 5395127682, 97 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.71 of 100Reported as apm

Quality

81.42

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

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.

• Barton Medical Foundation

  • Family Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1750950499

  NV

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1467517466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9578",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "96158",
            "telephone_number": "530-543-5896",
            "fax_number": "530-544-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10539 PROFESSIONAL CIR",
            "address_2": "SUITE 201",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503828",
            "telephone_number": "775-348-8800",
            "fax_number": "833-687-1419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1749 N Stewart St Ste 50",
            "address_purpose": "LOCATION",
            "city": "Carson City",
            "state": "NV",
            "postal_code": "897062574",
            "country_code": "US",
            "telephone_number": "775-348-8800",
            "fax_number": "833-687-1419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "780 Vista Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "NV",
            "postal_code": "894346677",
            "country_code": "US",
            "telephone_number": "775-348-8800",
            "fax_number": "833-687-1419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "935 Mica Dr Ste 13",
            "address_purpose": "LOCATION",
            "city": "Carson City",
            "state": "NV",
            "postal_code": "897057181",
            "country_code": "US",
            "telephone_number": "775-783-3065",
            "fax_number": "775-267-1829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 Highway 50 Fl 2",
            "address_purpose": "LOCATION",
            "city": "Stateline",
            "state": "NV",
            "postal_code": "894499816",
            "country_code": "US",
            "telephone_number": "775-589-8953",
            "fax_number": "775-589-8920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1139 3rd St",
            "address_purpose": "LOCATION",
            "city": "South Lake Tahoe",
            "state": "CA",
            "postal_code": "961503465",
            "country_code": "US",
            "telephone_number": "530-543-5706",
            "fax_number": "530-541-4130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2170 South Ave",
            "address_purpose": "LOCATION",
            "city": "South Lake Tahoe",
            "state": "CA",
            "postal_code": "961507026",
            "country_code": "US",
            "telephone_number": "530-543-5896",
            "fax_number": "530-544-6512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "AMY",
        "middle_name": "ANN",
        "credential": "OTR-L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "3665",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "0721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Viccaro
• Jennifer Victorio
• Margaret Vieira
• Olivia Vinup, AU.D.
• Viola Nungary LTD
• Christy Walowit
• Chelsea Walsh
• Leah Walsh, FNP-BC
• Amanda Stevens Weavil, MD
• Dustin John Wedekind

• Occupational Therapist in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.