HAROLD D WALLER (MD) – Surgery Physician, NPI 1063942209
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
198 VASCULAR SURGERY in MA
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Provider Addresses for HAROLD D WALLER (MD)
Massachusetts General Hospital, 55, Fruit Street, Beacon Hill, Boston, Suffolk County, Massachusetts, 02114, United States
55 FRUIT ST.
BOSTON, MA 02114
Phone: (617) 726-2558
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 38 Open Payments records for all available years, with a total value of $3,997.
Total Amount is formed as General ($3,997) + Research ($0) + Ownership ($0) = $3,997.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($3,449).
Total Amount
$3,997
General + Research + Ownership
Payments
38
Total payment records
General Amount
$3,997
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| W. L. Gore & Associates, Inc. | $3,449 |
| Cook Medical LLC | $195 |
| Penumbra, Inc. | $176 |
| Medtronic, Inc. | $51 |
| Organogenesis Inc. | $47 |
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: 2024-08-02
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 |
|---|---|---|---|---|
| I20240802000794 | I | Vascular Surgery | GA | 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 02114)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| General Surgery | SC | |
| Physician Assistant | TN | |
| Vascular Surgery, General Surgery | GA | |
| General Surgery, Vascular Surgery | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| Vascular Surgery | GA |
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