Nicholas Walle

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

LP00865 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-8450

Fax

(401) 444-5088

NPI assigned

Apr 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

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

Specialty

Diagnostic Radiology

Education

Georgetown University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Straub Clinic and Hospital Hospital, Honolulu, HI, CCN 120022
• Wilcox Memorial Hospital Hospital, Lihue, HI, CCN 120014
• The Queens Medical Center Hospital, Honolulu, HI, CCN 120001
• Pali Momi Medical Center Hospital, Aiea, HI, CCN 120026

Merit-based Incentive Payment System (MIPS)

Final score

83.72 of 100Reported as group

Quality

67.55

Promoting interoperability

100

Improvement activities

40

Cost

78.18

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Straub Clinic & Hospital

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1457306508
  Medicare reassignment Care Compare group NPD
• Kauai Medical Clinic

  • Multi-Specialty Clinic/Center
  • Lihue, HI
  • NPI 1376596643
  Medicare reassignment NPD
• Radiology Associates, Inc

  • Diagnostic Radiology Physician
  • Honolulu, HI
  • NPI 1205885134
  Medicare reassignment NPD
• Kauai Medical Clinic

  • Durable Medical Equipment & Medical Supplies
  • Koloa, HI
  • NPI 1871611558
  NPD
• Straub Clinic & Hospital

  • Community/Retail Pharmacy
  • Honolulu, HI
  • NPI 1295443216
  NPD

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

• Pali Momi Medical Center

  • General Acute Care Hospital
  • Aiea, HI
  • NPI 1013961408
  Care Compare affiliation
• Straub Clinic & Hospital

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1720031701
  Care Compare affiliation
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  Care Compare affiliation
• Wilcox Memorial Hospital

  • Rural Acute Care Hospital
  • Lihue, HI
  • NPI 1225113442
  Care Compare affiliation

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770701872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8450",
            "fax_number": "401-444-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8450",
            "fax_number": "401-444-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLE",
        "first_name": "NICHOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "LP00865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gemma Wallace, PHD
• Jacqueline Wallace, RN
• Jailene Wallace, FNP-C
• Joan Wallace, NP
• Paul Michael Wallace, MD
• Ann Marie Wallick, CRNA
• Brittany Meaghan Wallin, CRNA
• Barbara Anne Walsh Egan
• Caroline Walsh, MD, MPAFF
• Carolyn Walsh, LICSW

• Diagnostic Radiology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Diagnostic Radiology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.