KATIE JUSTINE WALLACE FNP-BC NPI 1790151967

NPI Information

  • NPI: 1790151967
  • Provider Name: KATIE JUSTINE WALLACE, FNP-BC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: MASHPEE FAMILY MEDICINE 5 INDUSTRIAL DRIVE
    SUITE 100
    MASHPEE, MA
    ZIP 02649
  • Phone: (508) 477-4282

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NPI Details

Katie Justine Wallace, FNP-BC is a family nurse practitioner in Mashpee, MA with 12 years of experience. Katie Justine Wallace, FNP-BC NPI is 1790151967. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

MASHPEE FAMILY MEDICINE 5 INDUSTRIAL DRIVE
SUITE 100
MASHPEE, MA
ZIP 02649
Phone: (508) 477-4282
Fax: (508) 539-6134

The NPI 1790151967 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)
  • Follow-up nursing facility visit per day, typically 15 minutes (HCPCS:99308)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Follow-up nursing facility visit per day, typically 25 minutes (HCPCS:99309)
  • Hospital discharge day management, more than 30 minutes (HCPCS:99239)
  • Follow-up nursing facility visit per day, typically 10 minutes (HCPCS:99307)
  • Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Initial hospital observation care per day, typically 70 minutes (HCPCS:99220)
  • Follow-up nursing facility visit per day, typically 35 minutes (HCPCS:99310)
  • Hospital observation care on day of discharge (HCPCS:99217)
  • Nursing facility discharge management, more than 30 minutes (HCPCS:99316)
  • Initial nursing facility visit per day, typically 45 minutes (HCPCS:99306)
  • Initial hospital observation care per day, typically 50 minutes (HCPCS:99219)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)

The enumeration date for this NPI number is 8/11/2015 and was last updated on 1/4/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerRN2264353MASSACHUSETTSNo
2363LF0000XNurse PractitionerFamilyRN2264353MASSACHUSETTSYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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