Steven B Wallach, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2113 Issued in AZ

Practice address

3005 W Ina Rd
Suite 123
Tucson, AZ 85741-2107

Phone

(520) 575-9110

Fax

(520) 575-8033

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Steven B Wallach DO

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1376660241
  NPD (past) Authorized official
• Healthtap Medical Group, P.C.

  • General Practice Physician
  • Portola Valley, CA
  • NPI 1518330539
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114027117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 W INA RD",
            "address_2": "SUITE 123",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857412107",
            "telephone_number": "520-575-9110",
            "fax_number": "520-575-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 W INA RD",
            "address_2": "SUITE 123",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857412107",
            "telephone_number": "520-575-9110",
            "fax_number": "520-575-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "STEVEN",
        "middle_name": "B",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "2113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260703",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "AZ0064670",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neil Wallace, MD
• Robert Dean Wallace, PT
• Ryan Wallace, P.T., D.P.T.
• Shawnesha Wallace, BCBA, LBA
• Stephanie Wallace, PA-C
• Keira Wallenborn, MA, CCC-SLP
• Kaylee Wallentine
• Candice Waller, LPC-MHSP
• Kurt David Wallin, D.M.D.
• Salley A Wallin, LCSW, MSW

• Family Medicine Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.