DR. MARK S WALLIS (M.D.) – MOHS-Micrographic Surgery Physician, NPI 1861489049

DR. MARK S WALLIS (M.D.) is a healthcare provider. based in Longview, Texas. specializing in DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. H6685 (TX). The NPI Number for DR. MARK S WALLIS (M.D.) is 1861489049

Main info

Male
Sole Proprietor
38 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK S WALLIS (M.D.)
NPI
1861489049
Phone
(903) 757-3881
Address
6 DOCTOR CIR
Enumeration Date
3 October 2005
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Secondary Phone
9037573881
Graduation Year
1988 (38 years ago)
PAC ID
7113057563
Group Practice PAC ID
0749440188
Professional Enrollment ID
I20100610000658
Address ID
TX756050036LO3535XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,284 DERMATOLOGY in TX

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Provider Addresses for DR. MARK S WALLIS (M.D.)

  • Wallis Dermatology Associates, 6, Doctor Circle, Longview, Gregg County, Texas, 75605, United States

    LONGVIEW, TX 756055050

    Phone: (903) 757-3881

    Fax: (903) 757-5948

    Type: Mailing

  • 3535 N FOURTH ST STE 400

    LONGVIEW, TX 756050038

    Phone: (903) 757-3881

    Fax: (903) 757-5948

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 197 Open Payments records for all available years, with a total value of $3,752.

Total Amount is formed as General ($3,752) + Research ($0) + Ownership ($0) = $3,752.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($719).

Total Amount

$3,752

General + Research + Ownership

Payments

197

Total payment records

General Amount

$3,752

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

View all Open Payments →|Open Payments Risk Radar →

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: 2010-06-10

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
I20100610000658IDermatologyTXTBD

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
J7345Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg3,00011$0
88305Pathology examination of tissue using a microscope, intermediate complexity1,8641,147$0
17003Destruction of precancer skin growth, 2-14 growths1,304199$0
99213Established patient office or other outpatient visit, 20-29 minutes386293$0
17000Destruction of precancer skin growth, 1 growth312234$0
View full utilization report →

Insurance plans in this area (ZIP 75605)

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Provider's Procedures

DR. MARK S WALLIS (M.D.) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYTX11101Biopsy of each additional growth of skin and/or tissue9060
DERMATOLOGYTX13132Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet3939
DERMATOLOGYTX14060Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips2828
DERMATOLOGYTX17003Destruction of 2-14 skin growths3450468

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: 0749440188View full group profile
NameSpecialtyState
Nurse PractitionerTX
D E R M A T O L O G YTX
D E R M A T O L O G YTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
D E R M A T O L O G YTX
Nurse PractitionerTX
Physician AssistantTX
D E R M A T O L O G YTX

Reviews

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Frequently asked questions

Does DR. MARK S WALLIS (M.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. MARK S WALLIS (M.D.) uses 1861489049.
Does CMS list DR. MARK S WALLIS (M.D.) as active?
Yes — DR. MARK S WALLIS (M.D.) is active in the NPI listing used on this page.
What is DR. MARK S WALLIS (M.D.) best known for clinically?
Directory data describes DR. MARK S WALLIS (M.D.) with MOHS-Micrographic Surgery Physician. Clinical services aligned with this taxonomy classification.
Where should I expect DR. MARK S WALLIS (M.D.) on a map?
Expect Longview, Texas as a primary anchor for DR. MARK S WALLIS (M.D.) unless the record lists multiple sites.
Is the information about DR. MARK S WALLIS (M.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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