DR. KENNETH A III WALLACE (MD) – MOHS-Micrographic Surgery Physician, NPI 1295791754
MOHS-Micrographic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,366 DERMATOLOGY in FL
Provider Addresses for DR. KENNETH A III WALLACE (MD)
1091 SE 59TH ST
OCALA, FL 344806146
Phone: (850) 597-0324
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 59 Open Payments records for all available years, with a total value of $3,948.
Total Amount is formed as General ($3,948) + Research ($0) + Ownership ($0) = $3,948.
Last reported payment date: 2024-12-31 • Largest payer in this snapshot: Biofrontera Inc. ($2,504).
Total Amount
$3,948
General + Research + Ownership
Payments
59
Total payment records
General Amount
$3,948
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Biofrontera Inc. | $2,504 |
| Regeneron Healthcare Solutions, Inc. | $358 |
| Janssen Biotech, Inc. | $304 |
| Organogenesis Inc. | $102 |
| ConvaTec Inc. | $73 |
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: 2009-09-12
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 |
|---|---|---|---|---|
| I20090912000065 | I | Dermatology | FL | 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 |
|---|---|---|---|---|
| J7345 | Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg | 18,200 | 51 | $0 |
| Q4282 | Cygnus dual, per square centimeter | 2,550 | 60 | $0 |
| 77280 | Obtaining data needed to develop the optimal radiation treatment, 1 treatment area | 2,215 | 152 | $0 |
| 77401 | Superficial and/or low voltage radiation treatment delivery | 2,146 | 171 | $0 |
| G6001 | Ultrasonic guidance for placement of radiation therapy fields | 2,144 | 138 | $0 |
Insurance plans in this area (ZIP 34480)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | FL | |
| Physician Assistant | FL | |
| Nurse Practitioner | FL | |
| Dermatology, Pathology | FL |
Reviews
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