SCOTT ANDREW WALLACE (M.D.) – Preventive Medicine/Occupational Environmental Medicine Physician, NPI 1275809899
Preventive Medicine/Occupational Environmental Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
85 PREVENTIVE MEDICINE in FL
Provider Addresses for SCOTT ANDREW WALLACE (M.D.)
Navy Medicine Support Command Attn: Med Staff Services
BLDG H 2005 Knight Lane
Jacksonville, FL 322120140
Phone: (619) 532-7935
Type: Location
8901 WISCONSIN AVE BLDG 85T
BETHESDA, MD 208890004
Phone: (301) 295-0786
Type: Mailing
11410 INTERLAAKEN DR SW
LAKEWOOD, WA 984985522
Phone:
Type: Mailing
NAVY MEDICINE SUPPORT COMMAND ATTN: MED STAFF SERVICES
BLDG H 2005 KNIGHT LANE
JACKSONVILLE, FL 322120140
Phone: (619) 532-7935
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $22.
Total Amount is formed as General ($22) + Research ($0) + Ownership ($0) = $22.
Last reported payment date: 2024-05-12 • Largest payer in this snapshot: Almatica Pharma LLC ($22).
Total Amount
$22
General + Research + Ownership
Payments
1
Total payment records
General Amount
$22
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Almatica Pharma LLC | $22 |
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: 2026-01-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20251024004108 | I | Preventive Medicine | MD | TBD |
| I20251024004149 | I | Preventive Medicine | DC | TBD |
| I20260124000397 | I | Preventive Medicine | VA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32212)
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