PAMELA J VANDERWALL (MD) – Radiation Oncology Physician, NPI 1225075609
Radiation Oncology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
186 RADIATION ONCOLOGY in WI
Provider Addresses for PAMELA J VANDERWALL (MD)
PO BOX 74950
LOS ANGELES, CA 900749560
Phone: (770) 693-2622
Fax: (770) 693-6039
Type: Mailing
11516 N PORT WASHINGTON RD STE 107
MEQUON, WI 530923478
Phone: (262) 241-5040
Fax: (262) 241-5261
Type: Mailing
2845 GREENBRIER RD
GREEN BAY, WI 543116519
Phone: (920) 288-4160
Type: Location
Flagstaff Medical Center, 1200, North Beaver Street, Hospital Hill, Flagstaff, Coconino County, Arizona, 86001, United States
FLAGSTAFF, AZ 860013118
Phone: (928) 773-2261
Fax: (928) 773-2263
Type: Location
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: 2005-06-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050603000352 | I | Radiation Oncology | WI | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 77014 | Ct guidance for insertion of radiation therapy fields | 769 | 118 | $0 |
| G6002 | Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy | 191 | 43 | $0 |
| 77300 | Calculation of radiation therapy dose | 135 | 41 | $0 |
| 77334 | Design and construction of complex radiation treatment device | 120 | 38 | $0 |
| 77427 | Radiation treatment management, 5 treatment sessions | 94 | 66 | $0 |
Insurance plans in this area (ZIP 90074)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Radiation Oncology | WI | |
| Radiation Oncology | WI | |
| Radiation Oncology | WI | |
| - | WI | |
| Radiation Oncology | CO | |
| Radiation Oncology | WI | |
| - | WI | |
| Radiation Oncology | WI | |
| Radiation Oncology | WI | |
| - | WI |
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