Ira B Wallace, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD032125E Issued in PA

Practice address

2 Bala Plaza
333 E City Avenue
Bala Cynwyd, PA 19004-1501

Phone

(610) 668-2777

Fax

(610) 668-1509

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Nevyas Eye Associates of NJ PC

  • Ambulatory Surgical Clinic/Center
  • Marlton, NJ
  • NPI 1174786743
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1316993124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BALA PLAZA",
            "address_2": "333 E CITY AVENUE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041501",
            "telephone_number": "610-668-2777",
            "fax_number": "610-668-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BALA PLAZA",
            "address_2": "333 E CITY AVENUE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041501",
            "telephone_number": "610-668-2777",
            "fax_number": "610-668-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "IRA",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD032125E",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD032125E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina E Vuono, SLP
• Hannah Wahner, PT
• Quincy X Waite, PT, DPT
• Christopher John Walder, RD, LDN
• Jeffrey Bail Walker, M.D.
• Keith Michael Walsh
• Leorah Miri Walsh, MD
• Margaret (Peggy) Mary Walsh, MS, LMFT
• Mariann Ward, NP
• Reginald Gregory Warner II, M.A., EDUCATION, LBS

• Ophthalmology Physician in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.