DAVID WALLACE PA-C
NPI 1720646672
Physician Assistant - Surgical in Stamford, CT
About David Wallace Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVID WALLACE PA-C (NPI 1720646672) is an individual surgical provider in Stamford, Connecticut, licensed in Connecticut (4572) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
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
David Wallace Pa-c 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.
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.
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.
STAMFORD, CT 06902
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 David Wallace's NPI number?
The NPI number for David Wallace is 1720646672. It was assigned to this individual provider in the NPPES registry on June 4, 2019.
Where is David Wallace located?
David Wallace practices at 1 Hospital Plz, Stamford, CT 06902. The listed phone number is (203) 276-1000.
What is David Wallace's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is David Wallace enrolled in Medicare?
Yes. David Wallace 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.
When was this NPI record last updated?
The NPPES record for David Wallace was last updated on September 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# David Wallace, PA-C · NPI 1720646672
Surgical physician in Stamford, Connecticut. Individual provider, active in the CMS NPPES registry since June 4, 2019.
## Identity
- **NPI:** 1720646672 (Entity type: Individual)
- **Enumerated:** June 4, 2019
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **State license:** 4572 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 1 HOSPITAL PLZ, Stamford, CT 06902-3602
- **Phone:** (203) 276-1000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** September 28, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1720646672) · Data from the CMS NPPES public registry.