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DR. ROY TRENT WALLACE MD NPI 1417946203


NPI Information

NPI: 1417946203
Provider Name: DR. ROY TRENT WALLACE, MD
Classification: Ophthalmology - 207WX0107X
Entity Type: Individual

Specialization: Retina Specialist

Organization: TENNESSEE RETINA PC

PECOS Registration: Yes

Address:
345 23RD AVE N
SUITE 350
NASHVILLE, TN
ZIP 37203
Phone: (615) 983-6000
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DR. Roy Trent Wallace, MD is a retina specialist ophthalmology in Nashville, TN with 38 years of experience. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. DR. Roy Trent Wallace, MD NPI is 1417946203. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1986

The provider's business location address is:

345 23RD AVE N
SUITE 350
NASHVILLE, TN
ZIP 37203-596
Phone: (615) 983-6000
Fax: (615) 983-6010

The NPI 1417946203 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.

  • Diagnostic imaging of retina (HCPCS:92134)
  • Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
  • Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
  • Photography of the retina (HCPCS:92250)

The enumeration date for this NPI number is 10/14/2005 and was last updated on 12/1/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmology30794KENTUCKYNo
2207W00000XOphthalmologyMD0000023587TENNESSEENo
3207WX0107XOphthalmologyRetina SpecialistMD0000023587TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
130692021MEDICARE PINTENNESSEE
23069202MEDICARE PINTENNESSEE
3E65367MEDICARE UPIN
400554002MEDICARE PINKENTUCKY
53379053OTHERTENNESSEEMEDICARE/GROUP
664914617MEDICAIDKENTUCKY
73069202MEDICAIDTENNESSEE

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.