DR. GABRIEL ABRAHAM WALLACE (MD) – Vascular Surgery Physician, NPI 1609142074
Vascular Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
131 VASCULAR SURGERY in WA
Provider Addresses for DR. GABRIEL ABRAHAM WALLACE (MD)
1959 NE Pacific St
Seattle, WA 981956410
Phone: (206) 543-3687
Type: Location
10258 Southwest Hwy Ste A
Chicago Ridge, IL 604151361
Phone: (708) 346-9533
Fax: (708) 499-4312
Type: Location
10258 SOUTHWEST HWY STE A
CHICAGO RIDGE, IL 604151361
Phone: (708) 346-9533
Fax: (708) 499-4312
Type: Location
PO BOX 84992
CHICAGO, IL 606894992
Phone: (918) 710-3710
Fax: (918) 770-0058
Type: Mailing
12251 S 80TH AVE STE 1520
PALOS HEIGHTS, IL 604631290
Phone: (708) 923-4200
Fax: (708) 923-4201
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 25 Open Payments records for all available years, with a total value of $933.
Total Amount is formed as General ($933) + Research ($0) + Ownership ($0) = $933.
Last reported payment date: 2024-06-14 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($406).
Total Amount
$933
General + Research + Ownership
Payments
25
Total payment records
General Amount
$933
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| W. L. Gore & Associates, Inc. | $406 |
| Silk Road Medical, Inc. | $124 |
| Medtronic, Inc. | $71 |
| Boston Scientific Corporation | $52 |
| CVRx, Inc. | $38 |
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: 2019-07-01
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 |
|---|---|---|---|---|
| I20190701001294 | I | Vascular Surgery | IL | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 105 | 94 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 99 | 99 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 72 | 72 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 66 | 62 | $0 |
| 93880 | Ultrasound of both sides of head and neck blood flow | 66 | 64 | $0 |
Insurance plans in this area (ZIP 98195)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Diagnostic Radiology, Interventional Radiology | IL | |
| P A T H O L O G Y | IL | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | IL | |
| G A S T R O E N T E R O L O G Y | IL | |
| Internal Medicine | IL | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Internal Medicine | MN | |
| - | IL | |
| Physical Therapist In Private Practice | IL | |
| Nurse Practitioner | IL |
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