Stephen G Wallace, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

MA079166 Issued in NJ

Practice address

350 Young Ave Ste 200
Moorestown, NJ 08057-3146

Phone

(609) 702-1900

Fax

(609) 702-8455

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

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 NJ

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

Hematology/Oncology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regional Cancer Care Associates LLCGroup PAC ID 5294710091, 148 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Samaritan Healthcare and Hospice Hospice, Mount Laurel, NJ, CCN 311504
• Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
• Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061
• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
• Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

Merit-based Incentive Payment System (MIPS)

Final score

87.31 of 100Reported as individual

Quality

70.74

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Regional Cancer Care Associates LLC

  • Hematology & Oncology Physician
  • Toms River, NJ
  • NPI 1801850243
  Medicare reassignment Care Compare group NPD
• Regional Cancer Care Associates LLC

  • Hematology & Oncology Physician
  • Belleville, NJ
  • NPI 1447315502
  NPD
• Regional Cancer Care Associates LLC

  • Clinical Medical Laboratory
  • Little Silver, NJ
  • NPI 1770284820
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Samaritan Healthcare & Hospice Inc

  • Community Based Hospice Care Agency
  • Mount Laurel, NJ
  • NPI 1144227646
  Care Compare affiliation
• Virtua - Memorial Hospital Burlington County, Inc.

  • General Acute Care Hospital
  • Mount Holly, NJ
  • NPI 1134125016
  Care Compare affiliation
• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation
• Virtua Our Lady of Lourdes Hospital Inc

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024
  Care Compare affiliation
• Virtua Willingboro Hospital Inc

  • General Acute Care Hospital
  • Willingboro, NJ
  • NPI 1053316844
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1144255498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MAIN ST STE 601",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076017083",
            "telephone_number": "609-702-1900",
            "fax_number": "609-702-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 YOUNG AVE STE 200",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573146",
            "telephone_number": "609-702-1900",
            "fax_number": "609-702-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "STEPHEN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NJ",
            "license": "MA079166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3982071",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068837",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Viviani, MA, CCC-SLP
• Dana M Volk, PHARM D
• Brittany Lauren Von Hausch
• John J Walker Jr., PT
• Mark S Walker, D.M.D
• Maribeth Walter
• Jennifer Kurdzuk Walters, M.ED.
• Renee Elaine Wansley, MSW
• Jocelyn Rose Wardlaw, DO
• Amy Waronker-Silverstein, M.D.

• Hematology & Oncology Physician in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Hematology & Oncology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.