ROBERT C WALLER (MD) – Addiction Medicine (Internal Medicine) Physician, NPI 1326097809
Addiction Medicine (Internal Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,157 EMERGENCY MEDICINE in MI
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Provider Addresses for ROBERT C WALLER (MD)
4600 MONTGOMERY RD STE 400
CINCINNATI, OH 452122600
Phone: (513) 873-1269
Type: Mailing
615 ELSINORE PL STE 200
CINCINNATI, OH 452021457
Phone: (833) 510-4357
Type: Mailing
Spectrum Health Butterworth Hospital, 100, Michigan Street Northeast, Grand Rapids, Kent County, Michigan, 49503, United States
MC 845
GRAND RAPIDS, MI 495032560
Phone:
Type: Mailing
Sheldon Boulevard Southeast, Heritage Hill Historic District, Grand Rapids, Kent County, Michigan, 49503, United States
GRAND RAPIDS, MI 495034224
Phone: (616) 391-6120
Type: Location
446 MORGAN ST
CINCINNATI, OH 452062348
Phone: (833) 510-4357
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.
This can happen when there are no reportable CMS Open Payments records.
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: 2023-05-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20060508000719 | I | Emergency Medicine | MI | TBD |
| I20230508001853 | I | Addiction Medicine | VA | TBD |
| I20230510001804 | I | Addiction Medicine | KY | TBD |
| I20230512000913 | I | Addiction Medicine | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45212)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MI | |
| Emergency Medicine | MI | |
| Emergency Medicine | MI | |
| Family Practice | MI | |
| Emergency Medicine | IL | |
| - | GA | |
| Emergency Medicine | MI | |
| Emergency Medicine | MI | |
| Physician Assistant | MI | |
| - | MI |
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