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DAVID WALLACE M.D. NPI 1609804525


NPI Information

NPI: 1609804525
Provider Name: DAVID WALLACE, M.D.
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
340 W LINCOLN ST
BELLEVILLE, IL
ZIP 62220
Phone: (618) 233-6044
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David Wallace, M.D. is a cardiovascular disease internal medicine in Belleville, IL. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. David Wallace, M.D. NPI is 1609804525. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

340 W LINCOLN ST
BELLEVILLE, IL
ZIP 62220-900
Phone: (618) 233-6044
Fax: (618) 233-3287

The NPI 1609804525 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.

  • Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report (HCPCS:93010)
  • Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)
  • Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report (HCPCS:93280)
  • Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report (HCPCS:93018)
  • Nuclear medicine study of vessels of heart using drugs or exercise multiple studies (HCPCS:78452)
  • Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart (HCPCS:93458)

The enumeration date for this NPI number is 6/29/2006 and was last updated on 4/17/2017.


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
1207RC0000XInternal MedicineCardiovascular Disease036092919ILLINOISYes

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
137099690008OTHERGHP
2R03182MEDICARE PINILLINOIS
354656OTHERCMR
4E43629MEDICARE UPINILLINOIS
5093355OTHERHEALTH ALLIANCE
6235649OTHERWELLCARE
7107076OTHERMISSOURIBCBS MO
812269OTHERESSENCE
9235649OTHERHEALTHLINK
100360929191MEDICAIDILLINOIS
11060046618OTHERRR MEDICARE
12596500012MEDICARE PINILLINOIS
132501200OTHERSECURE HORIZONS
14P01024928OTHERILLINOISRAILROAD
151734162OTHERUHC
16E43629OTHERMERCY
17205943608MEDICAIDMISSOURI

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.