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DR. MARC KENNETH WALLACK M.D.
NPI 1679650683
Surgery - Surgical Oncology in New York, NY

Active since November 01, 2006PECOS EnrolledAccepts Medicare Assignment
1901 1ST AVE, RM 12A1, NEW YORK, NY 10029(212) 423-6614(212) 423-7913 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Marc Kenneth Wallack M.d. NPPES

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

DR. MARC KENNETH WALLACK M.D. (NPI 1679650683) is an individual surgical oncology provider in New York, New York, licensed in New York (185118) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Pittsburgh School Of Medicine (1970).

NPPES Registry Identity

NPI1679650683
Entity TypeIndividualMale
Primary Taxonomy2086X0206X
Provider Legal NameDR. MARC KENNETH WALLACKCredential: M.D.
Location Address1901 1ST AVE, RM 12A1New York, NY 10029-7404
Mailing Address1901 1st Ave, Rm 12a1New York, NY 10029-7404 · (212) 423-6614 · Fax (212) 423-7913
Phone(212) 423-6614
Fax(212) 423-7913
Sole ProprietorYes
Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 1970
Enumeration DateNovember 1, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1679650683 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Surgical OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2086X0206X
License✔ Licensed in NY · 185118
Definition
A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research.
1901 1ST AVE, New York, NY 10029
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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. Marc Kenneth Wallack 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.

PECOS PAC ID7416851696
PECOS Enrollment IDI20070712000649
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Marc Wallack reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Metropolitan Medical Practice Plan PC
Same address
General Practice
1901 1ST AVE
New York, NY 10029
  • Reassigned Medicare billing, New York enrollment
  • 623 clinicians in this Medicare group
NPI 1306138383 (212) 423-7337
New York City Health And Hospitals Corporation
1.0 mi
Skilled Nursing Facility
900 MAIN ST, ROOM A22-4
New York, NY 10044
  • Reassigned Medicare billing, New York enrollment
  • 1,615 clinicians in this Medicare group
NPI 1679581607 (212) 848-6263
Physician Affiliate Group Of New York PC
2.1 mi
Dietitian, Registered
506 LENOX AVE
New York, NY 10037
  • Reassigned Medicare billing, New York enrollment
  • 2,094 clinicians in this Medicare group
NPI 1013375526 (212) 939-2467

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 10029 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
$198.19 typical visit price
range $65.69 – $198.19
Typical copayment $49.54 (range $16.42 – $49.54)
Most-billed visit code 99205
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
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.

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.

KENNETH BOMPAROLA PA
Physician Assistant
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6262
ESEOGHENE INYANG AKAMUNE PHARMD
Pharmacist (Pharmacotherapy)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6262
JONATHAN CHABON MD
Emergency Medicine
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6684
KRITI BHANDARI MD
Student in an Organized Health Care Education/Training Program
1901 1ST AVE
NEW YORK, NY 10029
New York County (646) 988-5168
SEBASTIAN MARK MENDEZ
Psychiatry & Neurology (Psychiatry)
1901 1ST AVE
NEW YORK, NY 10029
New York County (646) 672-3143
KYRA QUYNN MANAYAN-LEONARD MD
Student in an Organized Health Care Education/Training Program
1901 1ST AVE
NEW YORK, NY 10029
New York County (844) 692-4692
ELENA ALAYETO LCSW
Social Worker (Clinical)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-8633
BEATA EDYTA POPIS-MATEJAK MD
Internal Medicine (Critical Care Medicine)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6771

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 Marc Wallack's NPI number?

The NPI number for Marc Wallack is 1679650683. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Where is Marc Wallack located?

Marc Wallack practices at 1901 1st Ave Rm 12a1, New York, NY 10029. The listed phone number is (212) 423-6614.

What is Marc Wallack's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Oncology, with taxonomy code 2086X0206X.

Is Marc Wallack enrolled in Medicare?

Yes. Marc Wallack 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 organizations bill Medicare for Marc Wallack's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marc Wallack reassigns Medicare benefits to 3 organizations: Metropolitan Medical Practice Plan PC (New York, NY), New York City Health And Hospitals Corporation (New York, NY) and Physician Affiliate Group Of New York PC (New York, NY). Each 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 Marc Wallack'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 Marc Wallack was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.