Dustin Mark Wallace, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD438369 Issued in PA

Practice address

100 Knowlson Ave
Beaver Falls, PA 15010-1634

Phone

(724) 891-2100

Fax

(724) 891-2735

NPI assigned

Aug 16, 2009

Last updated

Feb 26, 2024By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, MO, KS3 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 3

Specialty

Internal MedicineAlso: Gastroenterology

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Gastroenterology Associates PCGroup PAC ID 4688646235, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Jameson Hospital, New Castle, PA, CCN 390016
• Heritage Valley Beaver Hospital, Beaver, PA, CCN 390036

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dustinwallace@vga.allscriptsdirect.net

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.

• Valley Gastroenterology Associates PC

  • Gastroenterology Physician
  • Beaver Falls, PA
  • NPI 1891748877
  Medicare reassignment Care Compare group NPD
• Butler Medical Providers

  • Gastroenterology Physician
  • Butler, PA
  • NPI 1619493046
  Medicare reassignment NPD
• Four Seasons Endoscopy Center Inc

  • Endoscopy Clinic/Center
  • Beaver Falls, PA
  • NPI 1932153459
  Medicare reassignment NPD
• Steward Medical Group Inc.

  • Internal Medicine Physician
  • Brookfield, OH
  • NPI 1902347438

  PA

  Medicare reassignment NPD
• The Children's Mercy Hospital

  • Pediatrics Physician
  • Kansas City, MO
  • NPI 1851437719

  KS

  Medicare reassignment NPD
• Butler Medical Providers

  • Rural Health Clinic/Center
  • Fairmount City, PA
  • NPI 1386253854
  NPD
• Butler Medical Providers

  • Certified Registered Nurse Anesthetist
  • Butler, PA
  • NPI 1710591011
  NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD
• The Children's Mercy Hospital

  dba Children's Mercy Riverside Pharmacy - Mail

  • Mail Order Pharmacy
  • Riverside, MO
  • NPI 1235923194
  NPD

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

• Upmc Jameson

  • Adult Mental Health Clinic/Center
  • New Castle, PA
  • NPI 1336277953

  Hospital

  Care Compare affiliation
• Upmc Jameson

  • General Acute Care Hospital
  • New Castle, PA
  • NPI 1477538312
  Care Compare affiliation
• Upmc Jameson

  • Ambulatory Surgical Clinic/Center
  • New Castle, PA
  • NPI 1609920206

  Hospital

  Care Compare affiliation
• Valley Medical Facilities Inc

  dba Valley Medical Facilities Inc dba Heritage Valley Beaver

  • General Acute Care Hospital
  • Beaver, PA
  • NPI 1063422053
  Care Compare affiliation
• Valley Medical Facilities, Inc.

  dba The Medical Center, Beaver, Family Practice Center

  • General Acute Care Hospital
  • Beaver Falls, PA
  • NPI 1306989983
  Care Compare affiliation
• Valley Medical Facilities, Inc.

  dba Sewickley Valley Hospital, Staunton Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sewickley, PA
  • NPI 1528101458

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1250380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1679705214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KNOWLSON AVE",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150101634",
            "telephone_number": "724-891-2100",
            "fax_number": "724-891-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KNOWLSON AVE",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150101634",
            "telephone_number": "724-891-2100",
            "fax_number": "724-891-2735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2602 Wilmington Rd",
            "address_purpose": "LOCATION",
            "city": "New Castle",
            "state": "PA",
            "postal_code": "161051537",
            "country_code": "US",
            "telephone_number": "724-652-5505",
            "fax_number": "724-652-0519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DUSTIN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-16",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD438369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024783480001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Voices of Dignity Support Services LLC
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3223)
• Wal-Mart Stores East, LP (Vision Center 30-3223)
• Walgreen Co (Walgreens #09942)
• Elizabeth Anne Walker, LAT, ATC
• Samantha J Walsh, PA-C
• Christopher J Watterson, MD
• Tina Louise Watts
• Kristi K Weatherly, OD
• Rebecca Ann Welch, M.D.

• Internal Medicine Physician in Beaver Falls, PA
• Providers in Beaver Falls, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.