Scott Arthur Wallace, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-01140 Issued in NC

Practice address

3643 N Roxboro St
Durham Regional Hospital Emergency Department
Durham, NC 27704-2702

Phone

(919) 470-5345

NPI assigned

Nov 25, 2007

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

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Emergency Physicians PAGroup PAC ID 9931002078, 269 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.58 of 100Reported as group

Quality

75.66

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Wake Emergency Physicians PA

  • Emergency Medicine Physician
  • Raleigh, NC
  • NPI 1922063387
  Medicare reassignment Care Compare group
• Wake Emergency Physicians PA

  • Emergency Medicine Physician
  • Cary, NC
  • NPI 1043251960
  NPD
• Wake Emergency Physicians PA

  • Emergency Medicine Physician
  • Goldsboro, NC
  • NPI 1619758018
  NPD
• Cary Orthopaedic and Sports Medicine Specialists, P.a.

  • Specialist
  • Cary, NC
  • NPI 1447289731
  NPD (past)

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

{
    "created_epoch": "1195948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1265613855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15133",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277040133",
            "telephone_number": "919-470-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 N ROXBORO ST",
            "address_2": "DURHAM REGIONAL HOSPITAL EMERGENCY DEPARTMENT",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042702",
            "telephone_number": "919-470-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SCOTT",
        "middle_name": "ARTHUR",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-25",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Smith Wallace, NP-C
• Isaac Galen Wallace, LMBT
• Kayla J Wallace
• Lauren Rose Wallace, MSW, LCSWA
• Roberta Wallace
• Shelvey Jean Wallace, LCSW
• Stephen Russell Wallace, DO
• Todd A Wallace, PA-C
• Stacey Greanias Wallen, CGC
• Ethan Waller, RD, LDN

• Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.