Melissa A. Wallace, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

34007996W Issued in OH

Practice address

752 Waycross Rd
Cincinnati, OH 45240-3184

Phone

(513) 825-9595

Fax

(513) 589-3747

NPI assigned

Jul 5, 2005

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 OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/FmRItZc30RH60LjxwsIxQM4HGo6XcQXK/
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• CHMC Community Health Services Network

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1023637774
  Medicare reassignment NPD
• CHMC Community Health Services Network

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1245821271
  NPD
• CHMC Community Health Services Network

  • Pediatrics Physician
  • Batesville, IN
  • NPI 1053464305
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1669479713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 WAYCROSS RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452403184",
            "telephone_number": "513-825-9595",
            "fax_number": "513-589-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 WAYCROSS RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452403184",
            "telephone_number": "513-825-9595",
            "fax_number": "513-589-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MELISSA",
        "middle_name": "A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34007996W",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Wallace
• Marilyn Wallace
• Matthew Christopher Wallace, M.D.
• Mayon Joel Wallace
• Megan Wallace, CRNA
• Micah Wallace, CDCA
• Michael Wallace
• Michelle Wallace, DPT
• Michelle Wallace, NP
• Molly Wallace, RD, LD

• Pediatrics Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.