Active NPI 1124660592 Individual Practitioner Female Practitioner

Holly A Wallace , APNP

Nurse Practitioner • Summit, WI

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Holly Wallace, APNP is a certified Nurse Practitioner practicing in Summit, WI. With approximately 7 years of clinical experience since completing medical education in 2019, Holly Wallace delivers high-quality medical care to the local community at 36500 AURORA DR.

Holly Wallace maintains professional affiliations with Aurora Medical Group, Inc., Watertown Family Practice Associates, Sc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, urinalysis, manual test. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

36500 Aurora Dr

Summit, WI 530664899

Telephone 2624341000

Fax 2624345050

Associated Practice Facility / Clinic

🏢 Aurora Health Care Ventures Inc. Facility NPI 1376791020

Medicare Profile & Education

Medical School

Other

Graduation Year

2019

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Summit, WI

Experienced Practitioner (5-10 Yrs)

Practitioner Clinical Experience

7 Yrs -2.6 yrs vs City Avg

City Avg: 9.6 Yrs

State Avg: 12.1 Yrs

Regional Practice Density

32 Specialists

Practicing in Summit, WI (4030 Statewide)

Telehealth Adoption Rate

31.2% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

74.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wallace (7 Years) 7 Yrs

Summit Specialty Average (9.6 Years) 9.6 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
99213 Established patient office or other outpatient visit, typically 15 minutes	205	148	$270.00	$71.79
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	132	90	$380.00	$102.53
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	21	21	$390.00	$98.77
81002 Urinalysis, manual test	13	13	$20.00	$3.41
69209 Removal of impacted ear wax by washing	11	11	$75.00	$16.57

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	184	150	$302.61	$71.90
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	108	88	$453.33	$100.70
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	43	43	$363.14	$103.54
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$202.31	$45.26
87637 Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus	11	11	$420.00	$139.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	595	162	$200.17	$73.06
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	359	147	$250.00	$107.73
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	59	50	$465.00	$103.26
99336 Established patient assisted living visit, typically 40 minutes	54	35	$300.00	$109.20
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	32	32	$355.00	$105.16
99213 Established patient office or other outpatient visit, typically 15 minutes	25	23	$313.00	$72.95
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	24	19	$150.00	$55.04
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	15	14	$100.00	$35.15
G0008 Administration of influenza virus vaccine	11	11	$60.00	$27.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	773	144	$125.47	$55.59
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	759	162	$176.56	$73.67
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	266	130	$238.75	$109.29
99336 Established patient assisted living visit, typically 40 minutes	191	52	$279.83	$109.76
99335 Established patient assisted living visit, typically 25 minutes	144	52	$234.13	$77.60
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	64	49	$92.02	$35.56
99306 Initial nursing facility visit, typically 45 minutes per day	38	36	$259.19	$134.70
99316 Nursing facility discharge management, more than 30 minutes	38	36	$177.22	$84.87
99315 Nursing facility discharge day management, 30 minutes or less	13	12	$112.42	$58.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	1,560	236	$200.00	$75.07
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	380	148	$250.79	$110.83
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	219	101	$150.00	$56.43
99335 Established patient assisted living visit, typically 25 minutes	119	42	$276.00	$79.27
99306 Initial nursing facility visit, typically 45 minutes per day	104	93	$350.00	$137.91

Medical Specialties & State Licenses

CMS Verified: 2025-10-24

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License WI 9679

(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

100094369 (WI)

Hospital & Practice Group Affiliations

Watertown Family Practice Associates, Sc

127 Hospital Dr, Watertown, WI 530983303

Phone: 9202618500

Aurora Medical Group, Inc.

36500 Aurora Dr, Summit, WI 530664899

Phone: 2624345000

Secondary Practice Locations

2428 N Grandview Blvd Ste 102

Waukesha, WI 531886906

Phone: 2628755070

Practice Associates & Co-Workers

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

40 Associated Practitioners

Bijan Nezami

Internal Medicine - Critical Care Medicine

NPI 1003201625

Kody Lewis , PA-C

Physician Assistant

NPI 1013144393

Physician Assistant (Certified)

Dr. Vijay Johnson , MD

Internal Medicine - Critical Care Medicine

NPI 1023298072

Doctor of Medicine (M.D.)

Kelly Campbell , ANP-BC

Nurse Practitioner

NPI 1023395118

ANPBC

Dr. Brett Mclachlan , MD

Emergency Medicine

NPI 1023452661

Doctor of Medicine (M.D.)

Lea Van Heule , CAA

Anesthesiologist Assistant

NPI 1023658549

Career & Practice History Timeline

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

10 Historical Events

📍

Updated Business Mailing Address October 24, 2025

Registered at PO BOX 735044, CHICAGO, IL 606735044 (Tel: 8003262250)

📍

Updated Practice Location July 27, 2022

Registered at 36500 AURORA DR, SUMMIT, WI 530664899 (Tel: 2624341000)

📍

Updated Business Mailing Address July 27, 2022

Registered at 3301 W FOREST HOME AVE, MILWAUKEE, WI 532152843 (Tel: 2624341000)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 27, 2022

Nurse Practitioner (License #9679 in WI)

✅

NPI Profile Active October 17, 2019

NPI status registered as active in NPPES database

📍

Updated Practice Location October 17, 2019

Registered at 2428 N GRANDVIEW BLVD STE 102, WAUKESHA, WI 531886906 (Tel: 2628755070)

📍

Updated Business Mailing Address October 17, 2019

Registered at 2039 N GLENDALE RD, OCONOMOWOC, WI 530669106 (Tel: 2624901090)

👤

Provider Name / Credentials Updated October 17, 2019

Recorded as HOLLY WALLACE, APNP

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 17, 2019

Internal Medicine (License #9679-33 in WI)

🟢

Initial NPI Registration & Enumeration October 17, 2019

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: 1124660592

Entity Type:

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

Enumeration Date: October 17, 2019

Last Update: October 24, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 735044

Chicago, IL 606735044

Phone: 8003262250

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.