DR. ERIC LEE WALLACE M.D.
NPI 1780614529
Surgery in Cookeville, TN

Q: What is Eric Wallace's NPI number?

The NPI number for Eric Wallace is 1780614529. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Q: What is Eric Wallace's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Eric Wallace was last updated on October 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 04, 2006PECOS EnrolledAccepts Medicare Assignment

95.35/100

CMS Quality Rating

145 W 4TH ST STE 201, COOKEVILLE, TN 38501(931) 783-5515(931) 783-5513 Get Directions Write a Review

NPPES record last updated: October 14, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 27, 2023, Feb 8, 2022 (2 updates tracked since 2022).

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About Dr. Eric Lee Wallace M.d. NPPES

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

DR. ERIC LEE WALLACE M.D. (NPI 1780614529) is an individual surgery provider in Cookeville, Tennessee, licensed in Tennessee (71205) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Cookeville Regional Medical Center, and is a graduate of Vanderbilt University School Of Medicine (2001).

NPPES Registry Identity

NPI1780614529

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameDR. ERIC LEE WALLACECredential: M.D.

Location Address145 W 4TH ST STE 201Cookeville, TN 38501-2476

Mailing Address140 W 7th StCookeville, TN 38501-1726 · (931) 783-5515 · Fax (931) 783-5513

Phone(931) 783-5515

Fax(931) 783-5513

Sole ProprietorNo

Medical School CMSVanderbilt University School Of MedicineGraduated 2001

Enumeration DateJuly 4, 2006

Last NPPES UpdateOctober 14, 20252 updates tracked since enumeration

NPPES CertifiedOctober 14, 2025

✔ NPI 1780614529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in TN · 71205

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

145 W 4TH ST STE 201, Cookeville, TN 38501

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Other Identifiers 1

MedicaidQ096326TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health 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

Dr. Eric Lee 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 ID1759384852

PECOS Enrollment IDI20241126003585

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 4

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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

57 services57 patients

Repair of groin hernia using an endoscope 49650

This procedure involves the use of an endoscope, a thin tube with a camera, to repair a hernia in the groin area. The surgeon makes small incisions, inserts the endoscope, and uses special tools to fix the hernia. This minimally invasive technique often results in quicker recovery times.

19 services19 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

15 services15 patients

Removal of gallbladder using an endoscope 47562

This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.

13 services13 patients

Hospital Affiliations CMS Care Compare

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

Cookeville Regional Medical Center

Acute Care Hospitals · Cookeville, TN

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number440059

Location1 Medical Center BoulevardCookeville, TN 38501 · Putnam County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38501 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

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.

95.35/100

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

Scored through an Alternative Payment Model

Quality

84.22

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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