WALLACE CLEMENTS TARRY MD
NPI 1205804945
Surgery - Vascular Surgery in Mooresville, NC

Active since March 09, 2006PECOS EnrolledAccepts Medicare Assignment
95.35/100
CMS Quality Rating
146 MEDICAL PARK RD, STE 206, MOORESVILLE, NC 28117(704) 799-3939 Get Directions Write a Review

NPPES record last updated: July 16, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 16, 2024, May 9, 2023, Mar 13, 2023 and 54 more (57 updates tracked since 2018).

About Wallace Clements Tarry Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALLACE CLEMENTS TARRY MD (NPI 1205804945) is an individual vascular surgery provider in Mooresville, North Carolina, licensed in North Carolina (200200613) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Atrium Health Navicent The Medical Center, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1205804945
Entity TypeIndividualMale
Primary Taxonomy2086S0129X
Provider Legal NameWALLACE CLEMENTS TARRYCredential: MD
Location Address146 MEDICAL PARK RD, STE 206Mooresville, NC 28117-8528
Mailing AddressPo Box 19305Charlotte, NC 28219-9305
Sole ProprietorNo
Medical School CMSDuke University School Of MedicineGraduated 1989
Enumeration DateMarch 9, 2006
Last NPPES UpdateJuly 16, 202457 updates tracked since enumeration
NPI 1205804945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0129X
License Licensed in NC · 200200613
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Also ListedSurgeryTaxonomy 208600000X · License 200200613 (NC)
146 MEDICAL PARK RD, Mooresville, NC 28117

Secondary Practice Locations 4

Location 1101 E W T Harris Blvd, Ste 1213Charlotte, NC 28262-3485 · Phone (704) 863-1950
Location 2134 Medical Park Rd, Ste 111 - Adult CardiologyMooresville, NC 28117-8526 · Phone (704) 801-9100
Location 31237 Harding Pl, Ste 3100Charlotte, NC 28204 · Phone (704) 373-0212
Location 4447 McAlister Rd, STE 3200Lincolnton, NC 28092-4114 · Phone (980) 212-6300

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Wallace Clements Tarry Md 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.

PECOS PAC ID7416845268
PECOS Enrollment IDI20040304001159, I20250519003000
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
298 services242 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
107 services107 patients
Ultrasound of both sides of head and neck blood flow 93880
An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.
80 services77 patients
Ultrasound study of arm and leg arteries 93922
An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.
73 services68 patients
Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist 36902
This procedure involves inserting a needle or tube into your hemodialysis circuit, a system that cleans your blood when your kidneys can't. A balloon is then used to widen a narrow section of this circuit. A radiologist reviews the procedure to ensure accuracy.
37 services24 patients
Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts 93978
This procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps to detect abnormalities or blockages, ensuring your blood flows smoothly. It's painless and non-invasive.
37 services36 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Atrium Health Navicent The Medical Center

Acute Care Hospitals · Macon, GA
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110107
Location777 Hemlock StreetMacon, GA 31201 · Bibb County
Emergency services Birthing friendly

Carolinas Medical Center-Northeast

Acute Care Hospitals · Concord, NC
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340001
Location920 Church St NConcord, NC 28025 · Cabarrus County
Emergency services Birthing friendly

Lake Norman Regional Medical Center

Acute Care Hospitals · Mooresville, NC
2/5 CMS rating
OwnershipProprietary
CMS Certification Number340129
Location171 Fairview RoadMooresville, NC 28117 · Iredell County
Emergency services

Atrium Health University City

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340166
Location8800 North Tyron StreetCharlotte, NC 28262 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28117 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality84.22
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Preventive Medicine (Undersea and Hyperbaric Medicine)
146 MEDICAL PARK RD
MOORESVILLE, NC 28117
Internal Medicine
146 MEDICAL PARK RD, STE 106
MOORESVILLE, NC 28117
Nurse Anesthetist, Certified Registered
146 MEDICAL PARK RD, SUITE 108
MOORESVILLE, NC 28117
Surgery (Vascular Surgery)
146 MEDICAL PARK RD, STE 206
MOORESVILLE, NC 28117
Nurse Practitioner
146 MEDICAL PARK RD, STE 206
MOORESVILLE, NC 28117
Surgery (Vascular Surgery)
146 MEDICAL PARK RD, SUITE 102
MOORESVILLE, NC 28117
Obstetrics & Gynecology
146 MEDICAL PARK RD, SUITE 206
MOORESVILLE, NC 28117

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 Wallace Tarry's NPI number?

The NPI number for Wallace Tarry is 1205804945. It was assigned to this individual provider in the NPPES registry on March 9, 2006.

Where is Wallace Tarry located?

Wallace Tarry practices at 146 Medical Park Rd Ste 206, Mooresville, NC 28117. The listed phone number is (704) 799-3939.

What is Wallace Tarry's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Is Wallace Tarry enrolled in Medicare?

Yes. Wallace Tarry 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.

What insurance does Wallace Tarry accept?

Health plans from Blue Cross and Blue Shield of NC, Oscar Health Plan of North Carolina, Inc and UnitedHealthcare list Wallace Tarry as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Wallace Tarry affiliated with any hospitals?

According to CMS data, Wallace Tarry is affiliated with Atrium Health Navicent The Medical Center, Carolinas Medical Center-Northeast, Lake Norman Regional Medical Center and Atrium Health University City.

When was this NPI record last updated?

The NPPES record for Wallace Tarry was last updated on July 16, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.