WALLACE W PECK (M.D.) – Diagnostic Radiology Physician, NPI 1508810367
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,800 DIAGNOSTIC RADIOLOGY in CA
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Provider Addresses for WALLACE W PECK (M.D.)
Calle Pasadena, Asociación California, Sector 12, Villa El Salvador, Province of Lima, Lima Metropolitan Area, Lima, 15829, Peru
PASADENA, CA 911851555
Phone: (949) 764-5570
Fax: (949) 263-1639
Type: Mailing
Hoag Drive, Newport Heights, Newport Beach, Orange County, California, 92658, United States
NEWPORT BEACH, CA 926634162
Phone: (949) 764-5570
Fax: (949) 263-0473
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $462.
Total Amount is formed as General ($462) + Research ($0) + Ownership ($0) = $462.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Medtronic, Inc. ($187).
Total Amount
$462
General + Research + Ownership
Payments
16
Total payment records
General Amount
$462
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $187 |
| Stryker Corporation | $91 |
| Biosense Webster, Inc. | $55 |
| Teleflex LLC | $32 |
| Boston Scientific Corporation | $20 |
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: 2003-11-18
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 |
|---|---|---|---|---|
| I20031118000946 | I | Diagnostic Radiology | CA | 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 |
|---|---|---|---|---|
| 70450 | Ct scan head or brain without contrast | 753 | 666 | $0 |
| 70553 | Mri scan of brain before and after contrast | 294 | 279 | $0 |
| 70551 | Mri scan of brain without contrast | 255 | 252 | $0 |
| 71045 | X-ray of chest, 1 view | 194 | 176 | $0 |
| 72125 | Ct scan of upper spine without contrast | 135 | 131 | $0 |
Insurance plans in this area (ZIP 91185)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Radiology, Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | WA |
Reviews
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