DR. ROGER CHARLES WALLACE (M.D.) – Emergency Medicine Physician, NPI 1083645501

DR. ROGER CHARLES WALLACE (M.D.) is a healthcare provider. based in Valencia, California. specializing in EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. A71306 (CA). The NPI Number for DR. ROGER CHARLES WALLACE (M.D.) is 1083645501

Main info

Male
Sole Proprietor
28 Years Of Experience
Accepts Medicare Assignment
Name
DR. ROGER CHARLES WALLACE (M.D.)
NPI
1083645501
Phone
(661) 253-8112
Address
23845 MCBEAN PKWY
Enumeration Date
5 July 2006
Last Update Date
7 July 2008

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Secondary Phone
6612002000
Graduation Year
1998 (28 years ago)
PAC ID
9931170511
Group Practice PAC ID
6103739131
Professional Enrollment ID
I20040805000802
Address ID
CA913552001VA23845PKWY300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

5,791 EMERGENCY MEDICINE in CA

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Provider Addresses for DR. ROGER CHARLES WALLACE (M.D.)

  • Henry Mayo Newhall Hospital, 23845, McBean Parkway, Valencia, Santa Clarita, Los Angeles County, California, 91355, United States

    VALENCIA, CA 913552001

    Phone: (661) 253-8112

    Fax: (661) 253-8119

    Type: Location

  • PO BOX 661540

    ARCADIA, CA 910661540

    Phone: (626) 447-0296

    Fax: (626) 447-6057

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-08-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040805000802IEmergency MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making289274$0
93042Electrocardiogram (ecg) 1 to 3 leads with review by physician only180169$0
99284Emergency department visit with moderate level of medical decision making131128$0
99291Critical care, first 30-74 minutes7675$0
View full utilization report →

Insurance plans in this area (ZIP 91355)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103739131View full group profile
NameSpecialtyState
Emergency MedicineOH
Emergency MedicineMI
Emergency MedicineOH
Emergency MedicineCA
-DE
Critical Care (Intensivists), Anesthesiology, Emergency MedicineCA
Emergency MedicineCA
Emergency MedicineCA
-CA
Emergency MedicineCA

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Frequently asked questions

What number should I use to identify DR. ROGER CHARLES WALLACE (M.D.) for billing?
Administrative and clinical systems typically use NPI 1083645501 for DR. ROGER CHARLES WALLACE (M.D.).
Quick check: is DR. ROGER CHARLES WALLACE (M.D.) active?
Public NPPES data shows DR. ROGER CHARLES WALLACE (M.D.) with an active NPI status right now.
Which specialty label fits DR. ROGER CHARLES WALLACE (M.D.)?
NPPES ties DR. ROGER CHARLES WALLACE (M.D.) to Emergency Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to DR. ROGER CHARLES WALLACE (M.D.)?
The directory associates DR. ROGER CHARLES WALLACE (M.D.) with Valencia, California. Check all listed addresses for suites or satellite offices.
Who maintains DR. ROGER CHARLES WALLACE (M.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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