Roy Trent Wallace, MD

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

MD0000023587 Issued in TN

Practice address

345 23Rd Ave N
Suite 350
Nashville, TN 37203-1596

Phone

(615) 983-6000

Fax

(615) 983-6010

NPI assigned

Oct 14, 2005

Last updated

Dec 1, 2017By 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

Medicare fee-for-service enrollment

Enrolled in KY, TN2 enrollments

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 2

Specialty

Ophthalmology

Education

Emory University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tennessee Retina PCGroup PAC ID 3678553740, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tristar Centennial Medical Center Hospital, Nashville, TN, CCN 440161

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Tennessee Retina PC

  • Retina Specialist (Ophthalmology) Physician
  • Nashville, TN
  • NPI 1497828321

  KY

  Medicare reassignment Care Compare group NPD
• Wesley & Klippenstein, PC

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Nashville, TN
  • NPI 1023025475
  NPD
• Retina Consultants of Nashville

  • Ophthalmology Physician
  • Hendersonville, TN
  • NPI 1104984780
  NPD (past)

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

• HCA Health Services of Tennessee, Inc.

  dba Tristar Centennial Medical Center

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1023055126
  Care Compare affiliation

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1417946203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 23RD AVE N",
            "address_2": "SUITE 350",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031596",
            "telephone_number": "615-983-6000",
            "fax_number": "615-983-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 23RD AVE N",
            "address_2": "SUITE 350",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031596",
            "telephone_number": "615-983-6000",
            "fax_number": "615-983-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ROY",
        "middle_name": "TRENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "30794",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD0000023587",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TN",
            "license": "MD0000023587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Wallace
• Kathryn Wallace
• Matthew Wallace
• Nikki L Wallace, CRNA
• Rodger T Wallace, M.D.
• Sarah Wallace, PA
• Stuart C Wallace, CRNA
• Tift Palmer Wallace, CPNP
• Ahreanna Wallen, LMSW
• Christina Paige Waller, APRN

• Retina Specialist (Ophthalmology) Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Retina Specialist (Ophthalmology) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.