THOMAS EVANS WALLACE (MD) – Family Medicine Physician, NPI 1306882725
Family Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
6,100 FAMILY PRACTICE in PA
Provider Addresses for THOMAS EVANS WALLACE (MD)
145 SHAFFER ST
WILLIAMSPORT, PA 177026727
Phone: (570) 327-1335
Fax: (570) 321-7800
Type: Location
7 DOCK HILL RD
MIDDLEBURG, PA 178428910
Phone: (570) 837-2123
Fax: (570) 837-2185
Type: Mailing
1205, River Avenue, Williamsport, Lycoming County, Pennsylvania, 17701, United States
1ST FLOOR
WILLIAMSPORT, PA 177013724
Phone: (570) 323-5991
Fax: (570) 323-6578
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 247 Open Payments records for all available years, with a total value of $5,222.
Total Amount is formed as General ($5,222) + Research ($0) + Ownership ($0) = $5,222.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($1,170).
Total Amount
$5,222
General + Research + Ownership
Payments
247
Total payment records
General Amount
$5,222
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $1,170 |
| Lilly USA, LLC | $724 |
| Novo Nordisk Inc | $607 |
| ABBVIE INC. | $419 |
| AstraZeneca Pharmaceuticals LP | $211 |
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: 2006-05-01
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 |
|---|---|---|---|---|
| I20060501000426 | I | Family Practice | PA | 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 |
|---|---|---|---|---|
| J0897 | Injection, denosumab, 1 mg | 3,840 | 41 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 1,519 | 363 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,040 | 555 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,007 | 509 | $0 |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 978 | 262 | $0 |
Insurance plans in this area (ZIP 17702)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | PA | 90670 | Pneumococcal vaccine for injection into muscle | 29 | 29 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, Emergency Medicine | PA | |
| Family Practice | PA | |
| Family Practice | PA | |
| Orthopedic Surgery | PA | |
| Internal Medicine | PA | |
| Family Practice | PA | |
| Family Practice | PA | |
| Anesthesiology, Pain Management | CT | |
| Physician Assistant | OH | |
| Urology, Obstetrics/Gynecology | MD |
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