Alex Wallace, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

52860 Issued in AZ

Practice address

13400 E Shea Blvd
Scottsdale, AZ 85259-5452

Phone

(480) 301-8000

NPI assigned

Apr 23, 2015

Last updated

Feb 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Diagnostic Radiology

Education

University of Arizona College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Hospital Hospital, Phoenix, AZ, CCN 030103

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mayo Clinic Arizona

  dba Mayo Clinic Scottsdale

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1558332494
  Medicare reassignment Care Compare group NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  Diagnostic Radiology

  Medicare reassignment NPD
• Mayo Clinic Arizona

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1699520049
  NPD

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

• Mayo Clinic Arizona

  dba Mayo Clinic Hospital

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1154392231
  Care Compare affiliation

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1316334675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ALEX",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-23",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "52860",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME145187",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AZ",
            "license": "52860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awallace395847@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Luke Walker, PA-C
• Robert Stephen Walker, MD
• Taylre Summerlynn Walker, FNP-C
• Suzanne U Wall, MSW, LCSW
• Thomas J Wall, MD
• Amanda Kay Wallace
• Andrew Nels Wallace, D.O.
• Cayce Wallace, DMD
• Jamie Russelle Wallace, MD
• Lauren Wallace

• Vascular & Interventional Radiology Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Vascular & Interventional Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.