Grant Meyer Wallace

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

35718 Issued in NE

Practice address

1600 S 48TH St
Lincoln, NE 68506-1283

Phone

(402) 483-3333

NPI assigned

Mar 20, 2014

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 NE

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

Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)

Education

University of Nebraska College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Cardiology Group LLCGroup PAC ID 7911803796, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bryan Medical Center Hospital, Lincoln, NE, CCN 280003
• Grand Island Regional Medical Center Hospital, Grand Island, NE, CCN 280139
• Crete Area Medical Center Hospital, Crete, NE, CCN 281354
• Community Hospital Hospital, McCook, NE, CCN 281363
• Memorial Health Care Systems Hospital, Seward, NE, CCN 281339

Merit-based Incentive Payment System (MIPS)

Final score

86.61 of 100Reported as group

Quality

87.74

Promoting interoperability

100

Improvement activities

40

Cost

67.62

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gwallace163647@hisp.bryanhealth.org

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.

• Integrated Cardiology Group LLC

  • Cardiovascular Disease Physician
  • Lincoln, NE
  • NPI 1982653515

  Clinical Cardiac Electrophysiology

  Medicare reassignment Care Compare group NPD
• Bryan Physician Network

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1679528798
  NPD (past)

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

• Bryan Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1528006103
  Care Compare affiliation
• Bryan Medical Center

  • Clinical Medical Laboratory
  • Lincoln, NE
  • NPI 1689203077

  Hospital

  Care Compare affiliation
• Bryan Medical Center

  • Diagnostic Radiology Physician
  • Lincoln, NE
  • NPI 1699384370

  Hospital

  Care Compare affiliation
• Community Hospital Association

  • Critical Access Hospital
  • McCook, NE
  • NPI 1841204500
  Care Compare affiliation
• Crete Area Medical Center

  • Critical Access Hospital
  • Crete, NE
  • NPI 1063463958
  Care Compare affiliation
• Grand Island Regional Medical Center

  • General Acute Care Hospital
  • Grand Island, NE
  • NPI 1558910604
  Care Compare affiliation
• Memorial Health Care Systems

  • Critical Access Hospital
  • Seward, NE
  • NPI 1770662512
  Care Compare affiliation

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1831516491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S 48TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061283",
            "telephone_number": "402-483-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "GRANT",
        "middle_name": "MEYER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-20",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NE",
            "license": "35718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia Grace Wall
• Melanie M Wall, PA-C
• Donald Joseph Walla, MD
• Addy Rae Wallace
• Blanca Wallace
• Jamieria Wallace
• Julie L Wallace
• Kathleen Wallace
• Miata Wallace, PA
• Sarah Rain Byrd Wallace

• Clinical Cardiac Electrophysiology Physician in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Clinical Cardiac Electrophysiology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.
• 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.