DR. CHARLES DOUGLAS WALLACE M.D.
NPI 1144229600
Orthopaedic Surgery in San Diego, CA
About Dr. Charles Douglas Wallace M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. CHARLES DOUGLAS WALLACE M.D. (NPI 1144229600) is an individual orthopaedic surgery provider in San Diego, California, licensed in California (G67953) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Michigan Medical School (1988).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Charles Douglas Wallace M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Charles Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Diego, CA 92123
- Reassigned Medicare billing, California enrollment
- 562 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92123 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92123
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Charles Wallace's NPI number?
The NPI number for Charles Wallace is 1144229600. It was assigned to this individual provider in the NPPES registry on July 18, 2005.
Where is Charles Wallace located?
Charles Wallace practices at 3030 Childrens Way Ste 410, San Diego, CA 92123. The listed phone number is (858) 966-6789.
What is Charles Wallace's specialty?
The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.
Is Charles Wallace enrolled in Medicare?
Yes. Charles Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Charles Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Charles Wallace reassigns Medicare benefits to Rady Children's Hospital San Diego (San Diego, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Charles Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Charles Wallace was last updated on November 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Charles Douglas Wallace, M.D. · NPI 1144229600
Orthopaedic Surgery physician in San Diego, California. Individual provider, active in the CMS NPPES registry since July 18, 2005.
## Identity
- **NPI:** 1144229600 (Entity type: Individual)
- **Enumerated:** July 18, 2005
- **Primary specialty:** Orthopaedic Surgery · taxonomy 207X00000X
- **State license:** G67953 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3030 CHILDRENS WAY, STE 410, San Diego, CA 92123-4232
- **Phone:** (858) 966-6789 · **Fax:** (858) 966-8519
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Rady Children's Hospital San Diego (NPI 1669617197, San Diego, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Michigan Medical School, class of 1988
## Record status
- **NPPES last updated:** November 2, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1144229600) · Data from the CMS NPPES public registry.