CARLY M WALLIS (M.S., RPA-C) – Physician Assistant, NPI 1992030316
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
Provider Addresses for CARLY M WALLIS (M.S., RPA-C)
817 FOREST AVE
ZANESVILLE, OH 437012820
Phone: (740) 454-7546
Type: Location
27, 8th Avenue, Park Slope, Brooklyn, Kings County, New York, 11217, United States
BROOKLYN, NY 112173901
Phone: (718) 636-0425
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 78 Open Payments records for all available years, with a total value of $1,661.
Total Amount is formed as General ($1,661) + Research ($0) + Ownership ($0) = $1,661.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($492).
Total Amount
$1,661
General + Research + Ownership
Payments
78
Total payment records
General Amount
$1,661
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $492 |
| E.R. Squibb & Sons, L.L.C. | $366 |
| Janssen Biotech, Inc. | $154 |
| Regeneron Healthcare Solutions, Inc. | $147 |
| Amgen Inc. | $76 |
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: 2018-03-22
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 |
|---|---|---|---|---|
| I20180322002370 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 1,267 | 204 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 388 | 318 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 351 | 265 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 220 | 180 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 169 | 147 | $0 |
Insurance plans in this area (ZIP 43701)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | NY | 17003 | Destruction of 2-14 skin growths | 341 | 43 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OH | |
| D E R M A T O L O G Y | OH | |
| P A T H O L O G Y | OH | |
| Physician Assistant | OH | |
| - | OH | |
| D E R M A T O L O G Y | OH | |
| D E R M A T O L O G Y | OH | |
| D E R M A T O L O G Y | OH | |
| D E R M A T O L O G Y | OH | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | OH |
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