Marcus Wallace, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

MD.025294 Issued in LA

Practice address

15790 Paul Vega MD Dr
Hospital Medicine
Hammond, LA 70403-1434

Phone

(985) 230-3066

Fax

(985) 230-2072

NPI assigned

Aug 11, 2006

Last updated

Feb 19, 2014By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Internal Medicine

Education

George Washington University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Tammany Parish Hospital Service District No 1Group PAC ID 0749273761, 162 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Tammany Parish Hospital Hospital, Covington, LA, CCN 190045

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Tammany Parish Hospital Service District No 1

  dba St. Tammany Parish Hospital

  • General Acute Care Hospital
  • Covington, LA
  • NPI 1598798597
  Medicare reassignment Care Compare group NPD
• St Tammany Parish Hospital Service District No 1

  dba St Tammany Physicians Network

  • Internal Medicine Physician
  • Covington, LA
  • NPI 1083793582
  NPD
• Greater Southeast Community Hospital Corp I

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1588736656
  NPD (past)

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

• St Tammany Parish Hospital Service District No 1

  dba St Tammany Physicians Network

  • Internal Medicine Physician
  • Covington, LA
  • NPI 1083793582

  Hospital

  Care Compare affiliation
• St Tammany Parish Hospital Service District No 1

  dba Northlake Pulmonary Associates at St Tammany Parish Hospital

  • Pulmonary Disease Physician
  • Covington, LA
  • NPI 1285285874

  Hospital

  Care Compare affiliation
• St. Tammany Parish Hospital Service District No 1

  dba St. Tammany Parish Hospital

  • General Acute Care Hospital
  • Covington, LA
  • NPI 1598798597
  Care Compare affiliation

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1841201860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2666",
            "address_2": "HOSPITAL MEDICINE",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704042666",
            "telephone_number": "985-230-3066",
            "fax_number": "985-230-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15790 PAUL VEGA MD DR",
            "address_2": "HOSPITAL MEDICINE",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031434",
            "telephone_number": "985-230-3066",
            "fax_number": "985-230-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MARCUS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "35540",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "LA",
            "license": "MD.025294",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.025294",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143374-01",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua N Walker, NP
• Justin Walker, ATC
• Latasha Walker, BSW
• Whitney Walker
• Brennan Wall
• Willie James Wallace Jr., LMSW
• Charlsa McGregor Waller, RN
• Daniel P. Waller, LOTR
• Clarence Walls
• Jeshanna Nicole Walter

• Hospitalist Physician in Hammond, LA
• Providers in Hammond, LA by specialty
• Hospitalist Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.