Tomi Lee Wall, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A97586 Issued in CA

Practice address

3300 Webster St
Suite 1106
Oakland, CA 94609-3117

Phone

(510) 763-2662

Fax

(510) 601-0750

NPI assigned

Oct 25, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Tomi Lee Pandolfino Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Dermatology

Education

Loyola University of Chicago, Stritch School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jerome R Potozkin MD, a Professional CorporationGroup PAC ID 4981893146, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.01 of 100Reported as group

Quality

93.81

Improvement activities

40

Cost

81.62

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drwallma@potozkin.emadirect.md

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.

• Jerome R Potozkin MD, a Professional Corporation

  • Dermatology Physician
  • Danville, CA
  • NPI 1093844292
  Medicare reassignment Care Compare group NPD
• Tomi Lee Wall MD PC

  • Dermatology Physician
  • Oakland, CA
  • NPI 1821794645
  NPD Authorized official
• T. Craig Williams M D a Prof Corp

  • Pulmonary Disease Physician
  • San Leandro, CA
  • NPI 1972630267
  NPD

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1417947060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST STE 1106",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093125",
            "telephone_number": "510-763-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST",
            "address_2": "SUITE 1106",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093117",
            "telephone_number": "510-763-2662",
            "fax_number": "510-601-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "TOMI",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A97586",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A97586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "462225",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J29028",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOMI",
            "last_name": "PANDOLFINO",
            "middle_name": "LEE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Renee Coulombe Walker
• Ronell Kiambu Walker
• Sonji Francine Walker, MSW
• Teresita S Walker
• Zeeyon Walker, PSY.D.
• Caitlin Elizabeth Wallace
• Dana Wallace
• Darrin J Wallace
• Dierdre Wallace
• Jacob Wallace II

• Dermatology Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.