Gregory S Wallin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036134280 Issued in IL

Practice address

1986 Mall PL
Benton Harbor, MI 49022-2332

Phone

(269) 945-5854

Fax

(369) 945-5854

NPI assigned

Jun 16, 2011

Last updated

Jan 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 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Family Practice

Education

Loma Linda University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pokagon Band of Potawatomi IndiansGroup PAC ID 3476455445, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

Merit-based Incentive Payment System (MIPS)

Final score

67.89 of 100Reported as group

Quality

100

Promoting interoperability

0

Improvement activities

40

Cost

76.31

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gregory.wallin.2@380.direct.athenahealth.com
• Direct secure messaging: gwallin1272518@epic00.shdirect.org

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.

• Pokagon Band of Potawatomi Indians

  dba Pokagon Health Service

  • Federally Qualified Health Center (FQHC)
  • Dowagiac, MI
  • NPI 1497833271

  TX

  Medicare reassignment Care Compare group NPD
• Pokagon Band of Potawatomi Indians

  dba Mshkiki Community Clinic Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Benton Harbor, MI
  • NPI 1790594349
  NPD

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

• Lakeland Hospitals at Niles and St Joseph, Inc

  dba Corewell Health Lakeland Hospitals

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1790070803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSHERE CIRCLE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606744035",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1986 MALL PL",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222332",
            "telephone_number": "269-945-5854",
            "fax_number": "369-945-5854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 Warrenville Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Lisle",
            "state": "IL",
            "postal_code": "605321348",
            "country_code": "US",
            "telephone_number": "630-548-0408",
            "fax_number": "306-528-3666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "GREGORY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036134280",
            "primary": true
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "IL",
            "license": "036134280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "gregory.wallin@dupagemd.com",
            "affiliation": "N",
            "address_1": "430 Warrenville Rd Ste 310",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605321348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gregory.wallin.2@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "135 N Oak St",
            "city": "Hinsdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605213860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-2062)
• Wal-Mart Stores East, LP (Vision Center 30-2062)
• Walgreen Co (Walgreens #10078)
• Candice Walker
• Michael Walker
• Walters Transportation
• Bryshunna Ward
• Chelsea Ward
• Edith P Ward, DPT
• Jennifer Warren

• Family Medicine Physician in Benton Harbor, MI
• Providers in Benton Harbor, MI by specialty
• Family Medicine Physician in Michigan

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