MARY JEAN WALL (MD) – Diagnostic Radiology Physician, NPI 1265405237
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,804 DIAGNOSTIC RADIOLOGY in OH
Provider Addresses for MARY JEAN WALL (MD)
108, West Main Street, Bellevue, Sandusky County, Ohio, 44811, United States
PO BOX 305
BELLEVUE, OH 448111328
Phone: (419) 483-4543
Fax: (419) 483-0142
Type: Mailing
1001 LAKESIDE AVE E STE 1200
CLEVELAND, OH 441141172
Phone: (216) 362-2000
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.
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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: 2004-08-19
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 |
|---|---|---|---|---|
| I20040819000075 | I | Diagnostic Radiology | OH | 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 |
|---|---|---|---|---|
| 77063 | Screening 3d breast mammography | 1,524 | 1,524 | $0 |
| 77067 | Screening mammography | 1,523 | 1,523 | $0 |
| 71045 | X-ray of chest, 1 view | 413 | 335 | $0 |
| 78815 | Nuclear medicine study from skull base to mid-thigh with ct scan | 253 | 219 | $0 |
| 77065 | Diagnostic mammography of 1 breast | 121 | 113 | $0 |
Insurance plans in this area (ZIP 44811)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | OH | 73630 | X-ray of foot, minimum of 3 views | 12 | 12 |
| DIAGNOSTIC RADIOLOGY | OH | 74177 | CT scan of abdomen and pelvis with contrast | 11 | 11 |
| DIAGNOSTIC RADIOLOGY | OH | 76830 | Ultrasound pelvis through vagina | 12 | 12 |
| DIAGNOSTIC RADIOLOGY | OH | 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 18 | 18 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | NC | |
| Diagnostic Radiology | OH | |
| Diagnostic Radiology | PA | |
| - | NC | |
| Diagnostic Radiology | CO | |
| Diagnostic Radiology | MN | |
| Interventional Radiology, Diagnostic Radiology | OH | |
| Diagnostic Radiology, Cardiac Surgery, Hematology, Interventional Radiology | VA | |
| Diagnostic Radiology | OH | |
| Diagnostic Radiology | IL |
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