DR. ROGER LEWIS WALLACE (D.O.) – Maternal & Fetal Medicine Physician, NPI 1609838481
Maternal & Fetal Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
3,164 OBSTETRICS/GYNECOLOGY in TX
Provider Addresses for DR. ROGER LEWIS WALLACE (D.O.)
1500 S Main St Fl 2
Fort Worth, TX 761044917
Phone: (817) 702-1081
Fax: (817) 702-1101
Type: Location
2401 S 31st St
Temple, TX 765087506
Phone: (254) 724-2111
Type: Location
2900, 12th Avenue North, Billings, Yellowstone County, Montana, 59101, United States
SUITE 130W
BILLINGS, MT 591017506
Phone: (406) 237-8400
Type: Mailing
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: 2022-03-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20060711000369 | I | Obstetrics/Gynecology | TX | TBD |
| I20220301002538 | I | Obstetrics/Gynecology | SD | 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 76104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pediatric Medicine | TX | |
| - | TX | |
| Critical Care (Intensivists), Pediatric Medicine | TX | |
| Neurology, Pediatric Medicine | TX | |
| Critical Care (Intensivists), Pediatric Medicine | TX | |
| Pediatric Medicine | TX | |
| Neurology, Pediatric Medicine | TX | |
| Pulmonary Disease | TX | |
| Diagnostic Radiology | TX | |
| Nephrology, Pediatric Medicine | TX |
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