RAY L WALLACE JR. PA
NPI 1720014624
Physician Assistant in Savannah, GA

Q: What is Ray Wallace's NPI number?

The NPI number for Ray Wallace is 1720014624. It was assigned to this individual provider in the NPPES registry on June 23, 2006.

Q: What is Ray Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Ray Wallace was last updated on February 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 23, 2006PECOS EnrolledAccepts Medicare Assignment

77.75/100

CMS Quality Rating

4425 PAULSEN ST, SAVANNAH, GA 31405(912) 355-6615(912) 351-0645 Get Directions Write a Review

NPPES record last updated: February 23, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Feb 23, 2021, May 30, 2019 (2 updates tracked since 2019).

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About Ray L Wallace Jr. Pa NPPES

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

RAY L WALLACE JR. PA (NPI 1720014624) is an individual physician assistant in Savannah, Georgia, licensed in Georgia (000935) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Pooler, and is a graduate of Other (1977).

NPPES Registry Identity

NPI1720014624

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameRAY L WALLACE JR.Credential: PA

Location Address4425 PAULSEN STSavannah, GA 31405-3662

Mailing Address4425 Paulsen StSavannah, GA 31405-3662 · (912) 355-6615 · Fax (912) 351-0645

Phone(912) 355-6615

Fax(912) 351-0645

Sole ProprietorNo

Medical School CMSOtherGraduated 1977

Enumeration DateJune 23, 2006

Last NPPES UpdateFebruary 23, 20212 updates tracked since enumeration

NPPES CertifiedFebruary 23, 2021

✔ NPI 1720014624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in GA · 000935

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

4425 PAULSEN ST, Savannah, GA 31405

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Secondary Practice Location 1

Location 1101 St Josephs Candler Dr Fl 1Pooler, GA 31322-9579 · Phone (912) 355-6615 · Fax (912) 351-0645

Other Identifiers 2

Medicaid203066747BGA

Medicaid203066747AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.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

Ray L Wallace Jr. Pa 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 ID8628095692

PECOS Enrollment IDI20051028000487

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 10

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

470 services61 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

168 services103 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

154 services72 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

60 services58 patients

Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose J7321

Hyaluronan or derivatives like Hyalgan, Supartz, or Visco-3, are used in intra-articular injections for joint pain relief. They help by improving joint lubrication, reducing inflammation, and promoting tissue healing. Each dose is administered directly into the joint space.

50 services14 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

41 services41 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31405 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

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.

77.75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

67.34

Promoting Interoperability

Improvement Activities

Cost

63.49

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.

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