DR. ELLEN CHRISTINE WALLACE M.D.
NPI 1720026552
Radiology - Diagnostic Radiology in Worcester, MA

Q: What is Ellen Wallace's NPI number?

The NPI number for Ellen Wallace is 1720026552. It was assigned to this individual provider in the NPPES registry on June 3, 2006.

Q: What is Ellen 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 Ellen Wallace was last updated on December 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 03, 2006PECOS Enrolled

55 LAKE AVE N, WORCESTER, MA 01655(508) 334-3850(774) 441-8443 Get Directions Write a Review

NPPES record last updated: December 8, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 8, 2023, Jun 2, 2021, Nov 25, 2020 (3 updates tracked since 2020).

On this page

About Dr. Ellen Christine Wallace M.d. NPPES

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

DR. ELLEN CHRISTINE WALLACE M.D. (NPI 1720026552) is an individual diagnostic radiology provider in Worcester, Massachusetts, licensed in Massachusetts (76584) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720026552

Entity TypeIndividualFemale

Primary Taxonomy2085R0202X

Provider Legal NameDR. ELLEN CHRISTINE WALLACECredential: M.D.

Location Address55 LAKE AVE NWorcester, MA 01655-0002

Mailing AddressPo Box 415348 Turnpike StationBoston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977

Phone(508) 334-3850

Fax(774) 441-8443

Sole ProprietorNo

Enumeration DateJune 3, 2006

Last NPPES UpdateDecember 8, 20233 updates tracked since enumeration

NPPES CertifiedDecember 8, 2023

✔ NPI 1720026552 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in MA · 76584

Definition

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

55 LAKE AVE N, Worcester, MA 01655

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Other Identifiers 1

Medicaid110053052AMA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ellen Christine 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 01655 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

$90.70 typical visit price

range $58.86 – $177.36

Typical copayment $22.67 (range $14.71 – $44.34)

Most-billed visit code 99203

Established Patient

$73.22 typical visit price

range $19.11 – $144.84

Typical copayment $18.30 (range $4.77 – $36.21)

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.

HILLARY R. IRONS MD

Emergency Medicine

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 421-1400

MS. EILEEN A. DUHAMEL NP

Nurse Practitioner

55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-2710

EWA HRYNISZYN CRNA

Nurse Anesthetist, Certified Registered

55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-3271

HELEN COPSEY PA-C

Physician Assistant

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-8585

DR. ADEPEJU GBADEBO CHAMPION M.D.

Internal Medicine

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-2731

SOWMYA KORAPATI

Internal Medicine (Hematology & Oncology)

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-3550

LAYLA FAKHRZADEH M.D.

Anesthesiology

55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-3271

YOONYIE CHO M.D.

Anesthesiology

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-1000

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 Ellen Wallace's NPI number?

The NPI number for Ellen Wallace is 1720026552. It was assigned to this individual provider in the NPPES registry on June 3, 2006.

Where is Ellen Wallace located?

Ellen Wallace practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 334-3850.

What is Ellen Wallace's specialty?

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

Is Ellen Wallace enrolled in Medicare?

Yes. Ellen Wallace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ellen Wallace was last updated on December 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.