DR. PRISCILLA JANE WALLACE (MD) – Diagnostic Radiology Physician, NPI 1932210069
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
532 DIAGNOSTIC RADIOLOGY in OR
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Provider Addresses for DR. PRISCILLA JANE WALLACE (MD)
EPIC Imaging, 233, Northeast 102nd Avenue, Russellville, Hazelwood, Portland, Metro, Multnomah County, Oregon, 97216, United States
PORTLAND, OR 972204106
Phone:
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 1 Open Payments records for all available years, with a total value of $26.
Total Amount is formed as General ($26) + Research ($0) + Ownership ($0) = $26.
Last reported payment date: 2023-05-17 • Largest payer in this snapshot: Hologic Sales and Service, LLC ($26).
Total Amount
$26
General + Research + Ownership
Payments
1
Total payment records
General Amount
$26
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Hologic Sales and Service, LLC | $26 |
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: 2004-03-17
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040317000042 | I | Diagnostic Radiology | OR | 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 |
|---|---|---|---|---|
| A9575 | Injection, gadoterate meglumine, 0.1 ml | 2,500 | 15 | $0 |
| 77067 | Screening mammography | 475 | 475 | $0 |
| 77063 | Screening 3d breast mammography | 474 | 474 | $0 |
| 77080 | Dxa bone density measurement of hip, pelvis, spine | 52 | 52 | $0 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 49 | 46 | $0 |
Insurance plans in this area (ZIP 97220)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | OR | 74177 | CT scan of abdomen and pelvis with contrast | 17 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | OR | |
| - | OR | |
| - | OR | |
| Diagnostic Radiology | TX | |
| - | OR | |
| - | OR | |
| - | OR | |
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | OR |
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