NPIMap

Individual provider Active NPI

Peter Glenn Wallick, M.D.

  • Plastic Surgery Physician
  • Chambersburg, PA
National Provider Identifier
1548360514
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
044-299-L Issued in PA
Practice address
2000 Scotland Ave
Chambersburg, PA 17201-1452
Phone
(717) 263-7788
Fax
(717) 263-7609
NPI assigned
Sep 22, 2006
Last updated
Dec 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 044-299-L PA Primary

Addresses

Primary practice location

2000 Scotland Ave
Chambersburg, PA 17201-1452

Mailing address

2000 Scotland Ave
Chambersburg, PA 17201-1452
Phone (717) 263-7788

Other identifiers 6

IdentifierTypeStateIssuer
001253180 0003MedicaidPA
001253180 0002MedicaidPA
678804OtherPABLUE SHIELD
347968700OtherPADEPT. OF LABOR (WC)
PO00756OtherPACHAMPUS-TRICARE
01041201OtherPABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100108000157 PA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 5496896748 Reassigns benefits to 1 organization
Practice locations: Chambersburg, PA

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Scotland Ave
Chambersburg, PA 17201-1452
Phone (717) 263-7788

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)11
Melanoma (skin cancer) excision119
Removal of skin lesions47
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
044-299-LPAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Dec 31, 2022 Accepting new patients
Pinnacle Health Medical Services CurrentSince Dec 31, 2022 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Pinnacle Health Medical Services Past Accepting new patients

Locations

144 S 8th St
Ste 107
Chambersburg, PA 17201
Phone (717) 414-7798

2000 Scotland Ave
Chambersburg, PA 17201
Phone (717) 263-7788

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

Interoperability endpoints

  • Direct secure messaging: pwallick306772@upmc.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1548360514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 SCOTLAND AVE",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011452",
            "telephone_number": "717-263-7788",
            "fax_number": "717-263-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 SCOTLAND AVE",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011452",
            "telephone_number": "717-263-7788",
            "fax_number": "717-263-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLICK",
        "first_name": "PETER",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "044-299-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001253180 0003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001253180 0002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "678804",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR (WC)",
            "identifier": "347968700",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-TRICARE",
            "identifier": "PO00756",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01041201",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chambersburg, PA

Sources for this page

Verify at the official NPI Registry.