Mark Allen Wallace, D.O.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

DO3910 Issued in ME

Practice address

15 Anchor Dr Ste 102
Rockport, ME 04856-3847

Phone

(207) 301-3660

Fax

(207) 301-5160

NPI assigned

Jul 27, 2007

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

Medicare fee-for-service enrollment

Enrolled in MP, ME2 enrollments

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 2

Specialty

Otolaryngology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Healthcare CorporationGroup PAC ID 7719075167, 79 clinicians

MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mainehealth Pen Bay Hospital Hospital, Rockport, ME, CCN 200063
• Commonwealth Health Center Hospital, Garapan, MP, CCN 660001
• Maine General Medical Center Hospital, Augusta, ME, CCN 200039
• Lincolnhealth Hospital, Damariscotta, ME, CCN 201302

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Mainehealth

  • Critical Access Hospital
  • Belfast, ME
  • NPI 1841397932
  Medicare reassignment Care Compare group NPD
• Commonwealth Healthcare Corporation

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saipan, MP
  • NPI 1285858290
  Medicare reassignment Care Compare group NPD
• Mainehealth

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment
• Mainehealth

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  • General Acute Care Hospital
  • Rockport, ME
  • NPI 1578043378
  NPD
• Commonwealth Healthcare Corporation

  • General Acute Care Hospital
  • Saipan, MP
  • NPI 1871616292
  NPD
• Alii Community Care, Inc

  • General Practice Physician
  • Kailua Kona, HI
  • NPI 1114127859
  NPD (past)
• Milford Regional Physician Group, Inc.

  • Sports Medicine (Family Medicine) Physician
  • Medway, MA
  • NPI 1508681321
  NPD (past)
• Milford Regional Physician Group, Inc.

  • Internal Medicine Physician
  • Milford, MA
  • NPI 1902856024
  NPD (past)

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

• Mainehealth

  • Critical Access Hospital
  • Damariscotta, ME
  • NPI 1912094806
  Care Compare affiliation
• Mainehealth

  • General Acute Care Hospital
  • Rockport, ME
  • NPI 1982645305
  Care Compare affiliation
• Commonwealth Healthcare Corporation

  • General Acute Care Hospital
  • Saipan, MP
  • NPI 1871616292
  Care Compare affiliation

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1952591828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ANCHOR DR STE 102",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048563847",
            "telephone_number": "207-301-3660",
            "fax_number": "207-301-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ANCHOR DR STE 102",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048563847",
            "telephone_number": "207-301-3660",
            "fax_number": "207-301-5160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 Northport Ave Ste 118",
            "address_purpose": "LOCATION",
            "city": "Belfast",
            "state": "ME",
            "postal_code": "049156096",
            "country_code": "US",
            "telephone_number": "207-505-4367",
            "fax_number": "207-338-4486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 Magazine St",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Sault Sainte Marie",
            "state": "MI",
            "postal_code": "497831867",
            "country_code": "US",
            "telephone_number": "906-259-0244",
            "fax_number": "906-259-0247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-27",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MI",
            "license": "5101015234",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ME",
            "license": "DO3910",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "ME",
            "license": "DO3910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney J Voisine, MD
• Elizabeth Vonfelten, M.D.
• Abebech Jobir Waktola, MD
• Elisabeth Walker Frederick, CNM
• Robert Brian Wall, NP
• Patrick T. Walsh, MT
• Jaclyn Walter, M.S. CF-SLP
• Mikala Walton, PMHNP-BC
• Thomas Waterhouse
• Colin Tiernan Waters, MD, PHD

• Otolaryngology/Facial Plastic Surgery Physician in Rockport, ME
• Providers in Rockport, ME by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; 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.