Scott Wallace, NP
NPI 1790442408 · Family Nurse Practitioner · Fairfield, CA
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Scott Wallace, NP is a Family Nurse Practitioner provider in Fairfield, CA (NPI 1790442408).
Provider details
- NPI number
- 1790442408
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP
- Sex
- Male
- Sole proprietor
- Yes
- License
- 459083 (CA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-11-17
- Last updated
- 2021-11-17
- Certified
- 2021-11-17
Frequently asked questions
- What is Scott Wallace's NPI number?
- Scott Wallace's National Provider Identifier (NPI) is 1790442408, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Scott Wallace's specialty?
- Scott Wallace is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Scott Wallace located?
- Scott Wallace's practice location on file with NPPES is 513 Silverado Cir, Fairfield, CA 94534-6818.
- What is Scott Wallace's phone number?
- The practice phone number listed in the NPPES registry for Scott Wallace is (707) 864-3240.
- Does Scott Wallace accept Medicare?
- Scott Wallace is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Scott Wallace's NPI active?
- Yes — Scott Wallace's NPI (1790442408) is active in the NPPES registry as of the last update on 2021-11-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.