Lailun Wallace, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301093013 Issued in MI

Practice address

5227 E Carefree Hwy
Cave Creek, AZ 85331-9173

Phone

(602) 824-3900

NPI assigned

Jul 24, 2008

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

Other names 1

• Ms. Lailun Kamal Wallace Other name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Emergency Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Group of Arizona Professional CorporationGroup PAC ID 1355596644, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honorhealth Tempe Medical Center Hospital, Phoenix, AZ, CCN 030037
• Abrazo Scottsdale Campus Hospital, Phoenix, AZ, CCN 030083

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.

• Emergency Group of Arizona Professional Corporation

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1215275433
  Medicare reassignment Care Compare group NPD
• Arizona Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1154860674
  Medicare reassignment NPD
• Emergency Physicians Southwest, PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1912053752
  Medicare reassignment NPD
• Loop 101 Emergency Physicians LLC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1376573378
  Medicare reassignment NPD
• Usacs Emergency Medicine of Arizona, LLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1770392490
  Medicare reassignment NPD
• Quantum Healthcare Medical Associates of Arizona, PC

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1821391269

  AZ

  Medicare reassignment NPD
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Durango, CO
  • NPI 1235765074

  AZ

  Medicare reassignment NPD
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Lakewood, CO
  • NPI 1720614217
  NPD
• Arizona Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1093254419
  NPD (past)
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)
• Mountain Vista Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1164642963
  NPD (past)
• Tempe Emergency Physicians, LTD

  • Emergency Medicine Physician
  • Bullhead City, AZ
  • NPI 1376934315
  NPD (past)

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

• Honorhealth

  • General Acute Care Hospital
  • Tempe, AZ
  • NPI 1114744752
  Care Compare affiliation
• VHS Acquisition Subsidiary Number 1 Inc

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1326022732
  Care Compare affiliation

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1942465356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13677 W MCDOWELL RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952635",
            "telephone_number": "718-308-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5227 E CAREFREE HWY",
            "city": "CAVE CREEK",
            "state": "AZ",
            "postal_code": "853319173",
            "telephone_number": "602-824-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LAILUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-24",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301093013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAILUN",
            "last_name": "WALLACE",
            "middle_name": "KAMAL",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Emergency Medicine Physician in Cave Creek, AZ
• Providers in Cave Creek, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.