WALLACE W PECK M.D. NPI 1508810367

NPI Information

  • NPI: 1508810367
  • Provider Name: WALLACE W PECK, M.D.
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: ONE HOAG DRIVE
    NEWPORT BEACH, CA
    ZIP 92663
  • Phone: (949) 764-5570

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NPI Details

Wallace W Peck, M.D. is a diagnostic radiology radiology in Newport Beach, CA with 43 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Wallace W Peck, M.D. NPI is 1508810367. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Graduation Year:1982

The provider's business location address is:

ONE HOAG DRIVE
NEWPORT BEACH, CA
ZIP 92663-162
Phone: (949) 764-5570
Fax: (949) 263-0473

The NPI 1508810367 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.

  • Ct scan head or brain without contrast (HCPCS:70450)
  • Mri scan of brain before and after contrast (HCPCS:70553)
  • Mri scan of brain without contrast (HCPCS:70551)
  • X-ray of chest, 1 view (HCPCS:71045)
  • Ct scan of upper spine without contrast (HCPCS:72125)
  • Ct scan of blood vessels of head with contrast (HCPCS:70496)
  • Ct scan of blood vessels of neck with contrast (HCPCS:70498)
  • Mri scan of blood vessels of head without contrast (HCPCS:70544)
  • Mri scan of lower spinal canal without contrast (HCPCS:72148)
  • X-ray of hip, 1 view (HCPCS:73501)
  • Mri scan of blood vessels of neck before and after contrast (HCPCS:70549)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Removal of spinal fluid with lower back spinal tap for diagnostic test using imaging guidance (HCPCS:62328)
  • Mri scan of upper spinal canal without contrast (HCPCS:72141)
  • Ct scan of lower spine without contrast (HCPCS:72131)
  • Ct scan of face without contrast (HCPCS:70486)
  • Mri scan of bone of eye socket, face, and/or neck before and after contrast (HCPCS:70543)
  • Mri scan of lower spinal canal before and after contrast (HCPCS:72158)
  • X-ray of pelvis, 1-2 views (HCPCS:72170)
  • Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes (HCPCS:99152)
  • X-ray of spine, 1 view (HCPCS:72020)
  • X-ray of lower and sacral spine, 2-3 views (HCPCS:72100)
  • X-ray of hip, 2-3 views (HCPCS:73502)
  • X-ray of knee, 1-2 views (HCPCS:73560)
  • X-ray of shoulder, 1 view (HCPCS:73020)
  • Ct scan of middle spine without contrast (HCPCS:72128)
  • 3d radiographic procedure with computerized image postprocessing (HCPCS:76377)
  • Complete ultrasound scan of abdomen (HCPCS:76700)
  • X-ray of knee, 3 views (HCPCS:73562)
  • Mri scan of middle spinal canal without contrast (HCPCS:72146)
  • Mri scan of upper spinal canal before and after contrast (HCPCS:72156)
  • Mri scan of middle spinal canal before and after contrast (HCPCS:72157)
  • X-ray of knee, 4 or more views (HCPCS:73564)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Core needle biopsy of lung or center cavity of chest (mediastinum), accessed through skin (HCPCS:32408)
  • Ct scan of lower spine with contrast (HCPCS:72132)
  • Review by radiologist of ct guidance for needle placement (HCPCS:77012)
  • X-ray of lower and sacral spine, minimum of 4 views (HCPCS:72110)

The enumeration date for this NPI number is 5/19/2006 and was last updated on 12/19/2007.

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
12085N0700XRadiologyNeuroradiologyG52810CALIFORNIANo
22085R0204XRadiologyVascular & Interventional RadiologyG52810CALIFORNIANo
32085R0202XRadiologyDiagnostic RadiologyG52810CALIFORNIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1WG52810HMEDICARE PINCALIFORNIA
200G528100OTHERCALIFORNIABLUE SHIELD
3WG52810JMEDICARE PINCALIFORNIA
4A52354MEDICARE UPIN
500G528100MEDICAIDCALIFORNIA
6WG52810IMEDICARE PINCALIFORNIA

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: 3/30/2025

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