Christopher Shawn Wallace, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

AK 201 Issued in AK

Practice address

8745 Glacier Hwy
Space 426
Juneau, AK 99801-8029

Phone

(907) 796-3937

NPI assigned

Nov 20, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

90.09 of 100Reported as group

Quality

100

Improvement activities

40

Cost

66.98

Medicare enrollment (NPD)

Enrolled

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.

• Samuel K. Seto MD PLLC

  • Specialist
  • Edmonds, WA
  • NPI 1497827711
  Medicare reassignment NPD

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790859528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8624 202ND ST SW",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980266644",
            "telephone_number": "206-419-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8745 GLACIER HWY",
            "address_2": "SPACE 426",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998018029",
            "telephone_number": "907-796-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CHRISTOPHER",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "AK 201",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD3752WA",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD 5342",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cecilia Waggoner
• Vince John Wagner, M.S. CCC-SLP
• Nell Ann Wagoner, MD
• Wal-Mart Stores Inc
• Shane Walker
• Christy J Wallace, RD, LD
• Erin Wallace
• Xavier Wallace
• Joan Waller, LMT
• Meredith M Wallis, CNM, ANP

• Optometrist in Juneau, AK
• Providers in Juneau, AK by specialty
• Optometrist in Alaska

• 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.