MARK WALLER (M.D.) – Anesthesiology Physician, NPI 1265494314

MARK WALLER (M.D.) is a healthcare provider. based in Tulsa, Oklahoma. specializing in ANESTHESIOLOGY. They hold the professional credentials M.D.. They hold a License No. 18067 (OK). The NPI Number for MARK WALLER (M.D.) is 1265494314

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
MARK WALLER (M.D.)
NPI
1265494314
Phone
(918) 744-3664
Address
1611 S UTICA AVE
Enumeration Date
4 April 2006
Last Update Date
28 May 2015

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
9183885701
Graduation Year
1991 (35 years ago)
PAC ID
3971527086
Group Practice PAC ID
5395767602
Professional Enrollment ID
I20060117000277
Address ID
OK741321843TU6901XAVEX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

580 ANESTHESIOLOGY in OK

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Provider Addresses for MARK WALLER (M.D.)

  • South Utica Avenue, Kendall Whitter-West, Tulsa, Tulsa County, Oklahoma, 74120, United States

    STE 217

    TULSA, OK 741044909

    Phone: (918) 744-3664

    Fax: (918) 748-7688

    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)

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: 2006-01-17

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060117000277IAnesthesiologyOKTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00145Anesthesia for retinal surgery2020$0
00142Anesthesia for lens surgery1919$0
00670Anesthesia for extensive surgery on spine1515$0
View full utilization report →

Insurance plans in this area (ZIP 74104)

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Provider's Procedures

MARK WALLER (M.D.) performs procedures in ANESTHESIOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ANESTHESIOLOGYOK36620Insertion of arterial catheter for blood sampling or infusion, accessed through the skin3333

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5395767602View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)OK
A N E S T H E S I O L O G YOK
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)TN
A N E S T H E S I O L O G YOK
-OK
A N E S T H E S I O L O G YOK
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)OK

Reviews

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Frequently asked questions

What federal number belongs to MARK WALLER (M.D.)?
The federal identifier for MARK WALLER (M.D.) is NPI 1265494314.
Does this profile mean MARK WALLER (M.D.) is currently active?
Yes — MARK WALLER (M.D.) appears active in the national provider directory.
Can you summarize MARK WALLER (M.D.)'s specialty in plain language?
Clinically, the directory lists MARK WALLER (M.D.) with Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Where does public data place MARK WALLER (M.D.)?
The snapshot lists Tulsa, Oklahoma for MARK WALLER (M.D.); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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