DR. ANDREW BLAKE WALLACE M.D.
NPI 1740626654
Radiology - Diagnostic Radiology in Saint Louis, MO

Active since May 18, 2013PECOS EnrolledAccepts Medicare Assignment
80.29/100
CMS Quality Rating
510 S KINGSHIGHWAY BLVD, MALLINCKRODT INSTITUE OF RADIOLOGY, SAINT LOUIS, MO 63110(314) 362-2978 Get Directions Write a Review

NPPES record last updated: May 5, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Andrew Blake Wallace M.d. NPPES

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

DR. ANDREW BLAKE WALLACE M.D. (NPI 1740626654) is an individual diagnostic radiology provider in Saint Louis, Missouri, licensed in North Carolina (2020-04583) and active in the NPI registry since May 2013. He is enrolled in Medicare PECOS, is affiliated with Onslow Memorial Hospital, and is a graduate of University Of North Carolina At Chapel Hill School Of Medicine (2013).

NPPES Registry Identity

NPI1740626654
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDR. ANDREW BLAKE WALLACECredential: M.D.
Location Address510 S KINGSHIGHWAY BLVD, MALLINCKRODT INSTITUE OF RADIOLOGYSaint Louis, MO 63110-1016
Mailing Address1025 Medical Center DrWilmington, NC 28401-7354 · (910) 762-3882
Sole ProprietorNo
Medical School CMSUniversity Of North Carolina At Chapel Hill School Of MedicineGraduated 2013
Enumeration DateMay 18, 2013
Last NPPES UpdateMay 5, 2021
NPPES CertifiedMay 5, 2021
NPI 1740626654 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 · 2020-04583 Licensed in MO · 2014013932
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
510 S KINGSHIGHWAY BLVD, Saint Louis, MO 63110

Accepted 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

Dr. Andrew Blake Wallace 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 ID1254552243
PECOS Enrollment IDI20210510001536
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 76

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, gadoterate meglumine, 0.1 ml A9575
Gadoterate meglumine is a contrast agent used in MRI scans to help visualize certain areas of your body more clearly. It's injected into your bloodstream, typically through a vein in your arm, and helps doctors get more detailed images.
4,700 services27 patients
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
4,430 services48 patients
X-ray of chest, 1 view 71045
A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.
592 services552 patients
Ct scan of abdomen and pelvis with contrast 74177
A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.
252 services248 patients
Ct scan of chest without contrast 71250
A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.
175 services174 patients
X-ray of abdomen, 1 view 74018
An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.
175 services164 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Onslow Memorial Hospital

Acute Care Hospitals · Jacksonville, NC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340042
Location317 Western BoulevardJacksonville, NC 28540 · Onslow County
Emergency services Birthing friendly

Novant Health New Hanover Regional Medical Center

Acute Care Hospitals · Wilmington, NC
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number340141
Location2131 S 17th St Box 9000Wilmington, NC 28402 · New Hanover County
Emergency services Birthing friendly

Novant Health Brunswick Medical Center

Acute Care Hospitals · Supply, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number340158
Location1 Medical Center Dr PO Box 139Supply, NC 28462 · Brunswick County
Emergency services Birthing friendly

Pender Memorial Hospital

Critical Access Hospitals · Burgaw, NC
OwnershipGovernment - Local
CMS Certification Number341307
Location507 E Fremont StBurgaw, NC 28425 · Pender County
Emergency services

J Arthur Dosher Memorial Hospital

Critical Access Hospitals · Southport, NC
OwnershipVoluntary non-profit - Other
CMS Certification Number341327
Location924 Howe StSouthport, NC 28461 · Brunswick County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63110 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
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.

80.29/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality95.07
Improvement Activities40
Cost43.34

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.

Radiology (Neuroradiology)
510 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63110
Radiology (Diagnostic Radiology)
510 S KINGSHIGHWAY BLVD, DEPT RADIOLOGY
SAINT LOUIS, MO 63110
Radiology (Diagnostic Radiology)
510 S KINGSHIGHWAY BLVD, DEPT RADIOLOGY
SAINT LOUIS, MO 63110
Radiology (Diagnostic Radiology)
510 S KINGSHIGHWAY BLVD, DEPT RADIOLOGY
SAINT LOUIS, MO 63110
Radiology (Diagnostic Radiology)
510 S KINGSHIGHWAY BLVD, DEPT RADIOLOGY
SAINT LOUIS, MO 63110
Radiology (Diagnostic Radiology)
510 S KINGSHIGHWAY BLVD, DEPT RADIOLOGY
SAINT LOUIS, MO 63110
Radiology (Diagnostic Radiology)
510 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63110
Radiology (Diagnostic Radiology)
510 S KINGSHIGHWAY BLVD, DEPT RADIOLOGY
SAINT LOUIS, MO 63110

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 Andrew Wallace's NPI number?

The NPI number for Andrew Wallace is 1740626654. It was assigned to this individual provider in the NPPES registry on May 18, 2013.

Where is Andrew Wallace located?

Andrew Wallace practices at 510 S Kingshighway Blvd Mallinckrodt Institue Of Radiology, Saint Louis, MO 63110. The listed phone number is (314) 362-2978.

What is Andrew Wallace's specialty?

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

Is Andrew Wallace enrolled in Medicare?

Yes. Andrew 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.

What insurance does Andrew Wallace accept?

Health plans from Blue Cross and Blue Shield of NC list Andrew Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Andrew Wallace affiliated with any hospitals?

According to CMS data, Andrew Wallace is affiliated with Onslow Memorial Hospital, Novant Health New Hanover Regional Medical Center, Novant Health Brunswick Medical Center, Pender Memorial Hospital and J Arthur Dosher Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Andrew Wallace was last updated on May 5, 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.