Individual provider Active NPI

Wallace I Lai I, MD

  • Clinical Cardiac Electrophysiology Physician
  • Salem, OR
National Provider Identifier
1578503249
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
MD17813 Issued in OR
Practice address
2480 Liberty St NE
Suite 110
Salem, OR 97301-8380
Phone
(503) 371-1756
Fax
(503) 584-7971
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X MD17813 OR Primary

Addresses

Primary practice location

2480 Liberty St NE
Suite 110
Salem, OR 97301-8380

Mailing address

2480 Liberty St NE
Suite 110
Salem, OR 97301-8380
Phone (503) 371-1756

Other identifiers 3

IdentifierTypeStateIssuer
060060218OtherORRAILROAD MEDICARE
100009591MedicaidOR
288256MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20040826000539 OR Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 4880668607 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Oregon Health Sciences University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Heart Center PCGroup PAC ID 1951438472, 12 clinicians

Practice addresses (Care Compare)

610 Hawthorne Ave SE
Suite 110
Salem, OR 97301-5378
Phone (503) 814-4440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.49 of 100Reported as group
Quality
76.77
Promoting interoperability
100
Improvement activities
40
Cost
88.8

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD17813ORMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tuality Healthcare Current Accepting new patients
Tuality Healthcare CurrentSince Oct 10, 2009 Accepting new patients
Tuality Healthcare CurrentSince Oct 10, 2009 Accepting new patients
Oregon Heart Center PC CurrentSince Jul 5, 2022 Accepting new patients
Tuality Medical Group LLC Current Accepting new patients
Salem Cardiology Arrhythmia Division, P.C. Clinical Cardiac Electrophysiology PastSince Jan 1, 2006 Accepting new patients
Salem Health Past Accepting new patients
Salem Health West Valley Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

364 SE 8th Ave
Ste 301
Hillsboro, OR 97123
Phone (503) 681-4233

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

875 Oak St SE
Ste 3090
Salem, OR 97301
Phone (503) 561-8550

875 Oak St SE
Ste 3060
Salem, OR 97301
Phone (503) 561-5170

610 Hawthorne Ave SE
Ste 110
Salem, OR 97301
Phone (503) 561-7160

875 Oak St SE
Ste 5040
Salem, OR 97301
Phone (503) 561-7170

Interoperability endpoints

  • Direct secure messaging: wlai3563087@oc.providencedirect.org

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1578503249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 LIBERTY ST NE",
            "address_2": "SUITE 110",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973018380",
            "telephone_number": "503-371-1756",
            "fax_number": "503-584-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LIBERTY ST NE",
            "address_2": "SUITE 110",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973018380",
            "telephone_number": "503-371-1756",
            "fax_number": "503-584-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAI",
        "first_name": "WALLACE",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "OR",
            "license": "MD17813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060060218",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100009591",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288256",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.