Katie Lynn Wallace, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2275454 Issued in MA

Practice address

67 S Bedford St Ste 101E
Burlington, MA 01803-5152

Phone

(781) 744-8085

NPI assigned

Sep 19, 2014

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 MA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Massachusetts Medical School, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermphysicians of New England LLCGroup PAC ID 0749522969, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
• Winchester Hospital Hospital, Winchester, MA, CCN 220105

Merit-based Incentive Payment System (MIPS)

Final score

91.98 of 100Reported as apm

Quality

76.59

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

91.98 of 100Reported as apm

Quality

76.59

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/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.

• Dermphysicians of New England LLC

  • Dermatology Physician
  • Burlington, MA
  • NPI 1558834523
  Medicare reassignment Care Compare group NPD
• Beth Israel Lahey Health Primary Care Inc

  • Clinic/Center
  • Middleboro, MA
  • NPI 1568292423
  Medicare reassignment NPD
• Lahey Clinic, Inc

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1063447316
  Medicare reassignment NPD
• Beth Israel Lahey Health Primary Care, Inc.

  • Urgent Care Clinic/Center
  • Lynnfield, MA
  • NPI 1922505072
  NPD
• Winchester Physician Associates

  • Internal Medicine Physician
  • North Reading, MA
  • NPI 1215919931
  NPD (past)

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

• Lahey Clinic Hospital, Inc.

  • General Acute Care Hospital
  • Burlington, MA
  • NPI 1558392563
  Care Compare affiliation
• Winchester Hospital

  • General Acute Care Hospital
  • Winchester, MA
  • NPI 1790740777
  Care Compare affiliation

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1952703092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050002",
            "telephone_number": "781-744-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 S BEDFORD ST STE 101E",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018035152",
            "telephone_number": "781-744-8085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018051550",
            "country_code": "US",
            "telephone_number": "781-744-8085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2275454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Numra Wahab
• Stephen Grant Wahlig, MD
• Mariah Waldron, M.S. CCC-SLP
• Bethany F Walker, CCC-SLP
• Chanda Wallace
• Elizabeth Catherine Walsh, PA-C
• Tomas R. Walsh, MD
• Edward D Walshe, M.D.
• Kaitlin Elyse Walton, AGACNP-BC
• Kenneth Joseph Walton, M.D.

• Family Nurse Practitioner in Burlington, MA
• Providers in Burlington, MA by specialty
• Family Nurse Practitioner in Massachusetts

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