Thomas Wallach, MD

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

272557 Issued in NY

Practice address

3959 Broadway
New York, NY 10032-1559

Phone

(202) 305-5437

NPI assigned

Mar 23, 2012

Last updated

Mar 27, 2023By 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

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: thomaswallach@sunydmc.allscriptsdirect.net
• Direct secure messaging: twallach1494775@nychhc.direct-ci.com

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.

• University Physicians of Brooklyn, Inc.

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1366506271
  Medicare reassignment NPD
• Bedford Medical Family Health Center, Inc.

  • Primary Care Clinic/Center
  • Brooklyn, NY
  • NPI 1295928489
  Medicare reassignment
• University Physicians of Brooklyn, Inc.

  dba Downstate Health Physicians

  • Pediatrics Physician
  • Brooklyn, NY
  • NPI 1649227190
  NPD
• University Physicians of Brooklyn, Inc.

  dba Downstate Health Physicians

  • Child & Adolescent Psychiatry Physician
  • Brooklyn, NY
  • NPI 1689715476
  NPD
• University Hospital of Brooklyn Suny Downstate Health Sciences Univers

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1639179328
  NPD (past)
• University Physicians of Brooklyn, Inc

  dba Downstate Health Physicians

  • Anesthesiology Physician
  • Brooklyn, NY
  • NPI 1104878180
  NPD (past)

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1801162870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-305-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "202-305-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-23",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "272557",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "272557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Wallach, MSW, LCSW
• Nadav Wallach, MD
• Robert Wallach, MD
• Sharry Wallach, O.T.
• Steven Gregg Wallach, MD
• Alison D Wallack, M.S.
• Joel J Wallack, M.D.
• Marc Kenneth Wallack, M.D.
• Anna Waller, PHD
• John Felix Waller, M.D.

• Pediatric Gastroenterology Physician in New York, NY
• Providers in New York, NY by specialty
• Pediatric Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.