Individual provider Active NPI

Africa F. Wallace, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Pennington, NJ
National Provider Identifier
1548279706
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
25MA10677300 Issued in NJ
Practice address
2 Capital Way Ste 356
Pennington, NJ 08534-2521
Phone
(609) 537-6000
Fax
(609) 537-6002
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD427591 PA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 070603 GA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD427591 PA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 25MA10677300 NJ Primary

Addresses

Primary practice location

2 Capital Way Ste 356
Pennington, NJ 08534-2521

Mailing address

2 Capital Way Ste 356
Pennington, NJ 08534-2521
Phone (609) 815-7829

Other practice location 1

95 Collier Rd NW
Suite 2055
Atlanta, GA 30309-1796
Phone (404) 605-5699

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address africa.wallace.1@12833.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20060330000432 PA Practitioner - Thoracic SurgeryPractitioner - Internal Medicine 6709894934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.91 of 100Reported as apm
Quality
79.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
070603GAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Health Medical Group Surgery CurrentSince Sep 1, 2019 Accepting new patients

Locations

3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

2 Capital Way
Ste 356
Pennington, NJ 08534
Phone (609) 537-6000

1050 Stony Hill Rd
Yardley, PA 19067
Phone (215) 504-1761

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1548279706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CAPITAL WAY STE 356",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342521",
            "telephone_number": "609-815-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CAPITAL WAY STE 356",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342521",
            "telephone_number": "609-537-6000",
            "fax_number": "609-537-6002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Collier Rd NW",
            "address_2": "Suite 2055",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303091796",
            "country_code": "US",
            "telephone_number": "404-605-5699",
            "fax_number": "404-355-4235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "AFRICA",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD427591",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "GA",
            "license": "070603",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD427591",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "25MA10677300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "africa.wallace.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Capital Way Ste 356",
            "city": "Pennington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085342521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pennington, NJ

Sources for this page

Verify at the official NPI Registry.