Thomas George Wack Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11364 Issued in WV

Practice address

616 Fairmont Pike RT 88
Wheeling, WV 26003

Phone

(304) 242-3550

Fax

(304) 242-5810

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

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

Family Practice

Education

West Virginia University School of Medicine, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Wheeling Hospital Inc

  • General Acute Care Hospital
  • Wheeling, WV
  • NPI 1104821305

  Corporate Director

  CMS ownership
• Wheeling Hospital Inc

  • Nursing Facility/Intermediate Care Facility
  • Wheeling, WV
  • NPI 1114913449

  Corporate Director

  CMS ownership

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.

• Wheeling Hospital Inc

  • Family Medicine Physician
  • Wheeling, WV
  • NPI 1548923923
  Medicare reassignment Care Compare group
• Wheeling Hospital, Inc.

  • Anesthesiology Physician
  • Wheeling, WV
  • NPI 1922282581
  NPD (past)

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

• Wheeling Hospital Inc

  • General Acute Care Hospital
  • Wheeling, WV
  • NPI 1104821305
  Care Compare affiliation

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1497803878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 FAIRMONT PIKE RT 88",
            "address_2": "PO BOX 2286",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-242-3550",
            "fax_number": "304-242-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 FAIRMONT PIKE RT 88",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-242-3550",
            "fax_number": "304-242-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACK",
        "first_name": "THOMAS",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "11364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0055858000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vintage Emergency Physicians, LLC
• Vna Home Support Services,Inc.
• Mark Thomas Voellinger, M.D.
• Nicole Marie Voellinger
• Ngoc Nguyen Dieu Vu, DPM
• Amy Wade, M.A, LPC, NCC, CTT
• Anna Marie Wade, CSW
• Javita Denise Wade
• Katrina Wade, PA-C
• Laura Wade L Wade

• Family Medicine Physician in Wheeling, WV
• Providers in Wheeling, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.