TERRY W WALLACE M.D.
NPI 1356335285
Radiology - Diagnostic Radiology in Charlotte, NC

Q: What is Terry Wallace's NPI number?

The NPI number for Terry Wallace is 1356335285. It was assigned to this individual provider in the NPPES registry on September 7, 2005.

Q: What is Terry Wallace's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Terry Wallace was last updated on December 20, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 07, 2005PECOS Enrolled

95.35/100

CMS Quality Rating

1701 EAST BLVD, CHARLOTTE, NC 28203(704) 334-7800(704) 414-7512 Get Directions Write a Review

NPPES record last updated: December 20, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 20, 2017, Dec 31, 2015 (2 updates tracked since 2015).

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About Terry W Wallace M.d. NPPES

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

TERRY W WALLACE M.D. (NPI 1356335285) is an individual diagnostic radiology provider in Charlotte, North Carolina, licensed in North Carolina (27411) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS and maintains a secondary practice location in Charlotte.

NPPES Registry Identity

NPI1356335285

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameTERRY W WALLACECredential: M.D.

Location Address1701 EAST BLVDCharlotte, NC 28203-5823

Mailing Address700 E Morehead St Ste 300Charlotte, NC 28202-2742 · (704) 334-7800 · Fax (704) 414-7512

Phone(704) 334-7800

Fax(704) 414-7512

Sole ProprietorNo

Enumeration DateSeptember 7, 2005

Last NPPES UpdateDecember 20, 20172 updates tracked since enumeration

✔ NPI 1356335285 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

Licenses✔ Licensed in NC · 27411✔ Licensed in MO · 2015014396✔ Licensed in GA · 071427✔ Licensed in MS · 23663✔ Licensed in TN · 49734✔ Licensed in SC · 20605✔ Licensed in VA · 0101256330✔ Licensed in AR · E-9305✔ Licensed in OK · 31321✔ Licensed in KY · 47635✔ Licensed in FL · ME118405

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

1701 EAST BLVD, Charlotte, NC 28203

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Secondary Practice Location 1

Location 11701 East BlvdCharlotte, NC 28203-5823 · Phone (704) 334-7800 · Fax (704) 414-7512

Other Identifiers 1

Medicaid8985523NC

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Terry W Wallace M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28203 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

Quality

84.22

Promoting Interoperability

100

Improvement Activities

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.

DR. ERIC D. ALPERT M.D.