Elizabeth Ainslie Wallace

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

124227 Issued in MA

Practice address

275 Concord Ave Apt 2
Cambridge, MA 02138-1396

Phone

(617) 406-7877

NPI assigned

Oct 10, 2022

Sex

Female

Sole proprietor

Yes

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 MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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.

• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573
  Medicare reassignment NPD
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Medicare reassignment NPD

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1821713173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 CONCORD AVE APT 2",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381396",
            "telephone_number": "617-406-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 CONCORD AVE APT 2",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381396",
            "telephone_number": "617-406-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ELIZABETH",
        "middle_name": "AINSLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "124227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Walker, LCSW
• Bruce David Walker, MD
• Eric Allein Walker, DMD
• Susan S Walker, M.D.
• Karin Maria Wall, LICSW
• Jennifer L Wallace, RN
• Karen L. Wallace, MD
• Katherine Chandler Wallace, PMHCNS-BC
• Linda M. Wallace, CCC-A
• Ryan J Wallace

• Clinical Social Worker in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.