Active NPI 1225035504 Individual Practitioner Female Practitioner

Kathleen Wallace , APN

Nurse Practitioner • Merrillville, IN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Kathleen Wallace, APN is a certified Nurse Practitioner practicing in Merrillville, IN. With approximately 39 years of clinical experience since completing medical education in 1987, Kathleen Wallace delivers high-quality medical care to the local community at 90 W 86TH AVE.

Kathleen Wallace is affiliated with Nephrology Associates Of Northern Indiana Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's, dialysis services, per day, less than full month service (20 years or older). Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

90 W 86th Ave

Merrillville, IN 464107086

Telephone 2197911555

Fax 2197911560

Associated Practice Facility / Clinic

🏢 Willow Springs Surgery Center, Llc Facility NPI 1467429233

Medicare Profile & Education

Medical School

Other

Graduation Year

1987

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Merrillville, IN

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

39 Yrs +28.4 yrs vs City Avg

City Avg: 10.6 Yrs

State Avg: 10.9 Yrs

Regional Practice Density

19 Specialists

Practicing in Merrillville, IN (2620 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

61.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wallace (39 Years) 39 Yrs

Merrillville Specialty Average (10.6 Years) 10.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	224	151	$234.88	$88.23
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	101	75	$30.12	$13.32

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	190	131	$235.86	$82.70
90970 Dialysis services, per day, less than full month service (20 years or older)	85	17	$17.46	$7.56
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	19	18	$544.34	$233.33
99213 Established patient office or other outpatient visit, typically 15 minutes	13	13	$166.20	$71.24
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	11	11	$655.68	$280.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99496 Transitional care management services for problem of high complexity	16	15	$620.00	$221.23

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	85	50	$648.00	$292.00
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	23	22	$540.00	$233.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
90970 Dialysis services, per day, less than full month service (20 years or older)	355	18	$17.00	$6.63
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	38	20	$648.00	$231.40
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	13	12	$540.00	$196.16

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
90970 Dialysis services, per day, less than full month service (20 years or older)	341	21	$17.00	$6.28
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	20	17	$648.00	$229.93
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	18	15	$540.00	$193.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	54	47	$648.00	$229.45
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	23	18	$540.00	$192.50
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	21	20	$133.00	$80.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	61	46	$133.00	$86.03
99213 Established patient office or other outpatient visit, typically 15 minutes	37	35	$86.00	$58.36
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	31	11	$648.00	$229.89
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	20	13	$540.00	$192.79

Medical Specialties & State Licenses

CMS Verified: 2022-12-13

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License IN 71000826A

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

100082060 (IN)

Medicaid State Provider ID

200280140B (IN)

Commercial Insurance / Payer ID Anthem Bcbs Number

000000331131 (IN)

Commercial Insurance / Payer ID Rr Medicare

500012853 (IN)

Hospital & Practice Group Affiliations

Nephrology Associates Of Northern Indiana Pc

90 W 86th Ave, Merrillville, IN 464107086

Phone: 2197911555

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

16 Associated Practitioners

Nicole Richards , FNP

Nurse Practitioner - Family

NPI 1033302955

Family Nurse Practitioner

Dr. Katrina Wright , MD

Internal Medicine - Nephrology

NPI 1073501136

Doctor of Medicine (M.D.)

Cindy Chapman , NURSE PRACTITIONER

Nurse Practitioner - Family

NPI 1104410968

NURSEPRACTITIONER

Dr. Ali Kheirbek , MD

Internal Medicine - Nephrology

NPI 1174520415

Doctor of Medicine (M.D.)

Dr. Kevin Myrie , MD

Internal Medicine - Nephrology

NPI 1316193162

Doctor of Medicine (M.D.)

Yves Frantz Brignol , MBA, HA, CMC

Internal Medicine - Nephrology

NPI 1396742748

Master of Business Administration, HA, CMC

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location November 13, 2020

Registered at 90 W 86TH AVE, MERRILLVILLE, IN 464107086 (Tel: 2197911555)

📍

Updated Business Mailing Address November 13, 2020

Registered at 120 W 22ND ST STE 200, OAK BROOK, IL 605231563 (Tel: 6305755000)

✅

NPI Profile Active January 21, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location January 21, 2008

Registered at 8668 BROADWAY, MERRILLVILLE, IN 464107034 (Tel: 2197911556)

📍

Updated Business Mailing Address January 21, 2008

Registered at 855 MADISON ST, OAK PARK, IL 603024420 (Tel: 7084924531)

👤

Provider Name / Credentials Updated January 21, 2008

Recorded as KATHLEEN WALLACE, APN

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 21, 2008

Nurse Practitioner (License #71000826A in IN)

🟢

Initial NPI Registration & Enumeration July 01, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1225035504

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 01, 2005

Last Update: December 13, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

120 W 22nd St Ste 200

Oak Brook, IL 605231563

Phone: 6305735000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.