NPIMap

Individual provider Active NPI

Levy Wallace, MD

  • Internal Medicine Physician
  • Danbury, CT
National Provider Identifier
1831719038
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
323872 Issued in NY
Practice address
120 Main St
Danbury, CT 06810-7834
Phone
(203) 743-0100
NPI assigned
Apr 17, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 76990 CT
Internal Medicine Physician 207R00000X 323872 NY Primary

Addresses

Primary practice location

120 Main St
Danbury, CT 06810-7834

Mailing address

120 Main St
Danbury, CT 06810-7834
Phone (203) 743-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231113002283 NY Practitioner - Internal Medicine 0840647806 Reassigns benefits to 1 organization
I20240409003404 CT Practitioner - Internal Medicine 0840647806 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Montefiore New Rochelle HospitalGroup PAC ID 0345474706, 62 clinicians
Midstate Medical CenterGroup PAC ID 7416840699, 187 clinicians

Practice addresses (Care Compare)

100 Grand St
New Britain, CT 06052-2016
Phone (860) 224-5121

16 Guion PL
New Rochelle, NY 10801-5502
Phone (914) 365-4065

435 Lewis Ave
Meriden, CT 06451-2101
Phone (203) 694-8200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as group
Quality
83.66
Promoting interoperability
100
Improvement activities
40
Cost
66.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
76990CTMDInternal Medicine Physician
323872NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midstate Medical Center Current Accepting new patients
Midstate Medical Center CurrentSince Apr 1, 2024 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Internal Medicine CurrentSince Apr 1, 2024 Accepting new patients
Midstate Medical Center CurrentSince Apr 1, 2024 Accepting new patients
Montefiore New Rochelle Hospital CurrentSince Sep 23, 2023 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Apr 1, 2024 Accepting new patients

Locations

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

20 Cedar St
New Rochelle, NY 10801
Phone (914) 576-5292

16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680

Networks

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

Interoperability endpoints

  • Direct secure messaging: levy.wallace@xdr.hhchealthdirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1831719038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MAIN ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107834",
            "telephone_number": "203-743-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MAIN ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107834",
            "telephone_number": "203-743-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LEVY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-17",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "76990",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "323872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.