Roger Lewis Wallace, D.O.

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

E4746 Issued in TX

Practice address

2900 12TH Ave N
Suite 130W
Billings, MT 59101-7506

Phone

(406) 237-8400

NPI assigned

Apr 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, SD2 enrollments

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 2

Specialty

Obstetrics/Gynecology

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Children'S Physician Services of South TexasGroup PAC ID 3678478872, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: roger.wallace@avera.sdhealthlink.net
• Direct secure messaging: roger.wallace.2@1603.direct.athenahealth.com
• Direct secure messaging: rwallace33274@direct.sclhealth.com

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.

• Children'S Physician Services of South Texas

  • Plastic Surgery Physician
  • Corpus Christi, TX
  • NPI 1568658227
  Medicare reassignment Care Compare group
• Acclaim Physician Group, Inc

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1780076562
  Medicare reassignment NPD
• Avera McKennan

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  Medicare reassignment NPD
• Big Bend Medical Group

  • Surgery Physician
  • Big Spring, TX
  • NPI 1811973282
  Medicare reassignment NPD
• Avera McKennan

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  • Maternal & Fetal Medicine Physician
  • Sioux Falls, SD
  • NPI 1205808748
  NPD
• Big Bend Medical Group

  • Rural Health Clinic/Center
  • Big Spring, TX
  • NPI 1790592004
  NPD

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1609838481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N",
            "address_2": "SUITE 130W",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591017506",
            "telephone_number": "406-237-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N",
            "address_2": "SUITE 130W",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591017506",
            "telephone_number": "406-237-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Main St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "817-702-1081",
            "fax_number": "817-702-1101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765087506",
            "country_code": "US",
            "telephone_number": "254-724-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ROGER",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "TX",
            "license": "E4746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwallace1151657@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 S 31st St",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765087506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen Sue Walker, LCSW
• Madison Alane Walker, OTD, OTR/L
• Melanie Ann Walker, NP-C
• Gordon Steven Wallace, L.C.P.C. / L.A.C.
• Paula J Wallace, MSW,LAC
• Sheila J Waller, PHYSICAL THERAPIST
• Sarah Lucille Wallick, D.O.
• Walman Optical Company
• Walmart Inc.
• Walmart Inc.

• Maternal & Fetal Medicine Physician in Billings, MT
• Providers in Billings, MT by specialty
• Maternal & Fetal Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.