DR. WALLACE THOMAS M.D.
NPI 1831490432
Hospitalist in West Palm Beach, FL

NPI Status: Active since November 12, 2010

Contact Information

300 EXECUTIVE CENTER DR
WEST PALM BEACH, FL
ZIP 33401
Phone: (561) 201-3234

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  • Individual
  • Male
  • Years of Experience 19
  • Hospitalist
  • PECOS Enrolled
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About WALLACE THOMAS

Wallace Thomas is a provider established in West Palm Beach, Florida and his medical specialization is Hospitalist with more than 19 years of experience. The healthcare provider is registered in the NPI registry with number 1831490432 assigned on November 2010. The practitioner's primary taxonomy code is 208M00000X with license number ME126338 (FL). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1831490432
Provider Name
DR. WALLACE THOMAS M.D.
Gender
Male
Entity Type
Individual
Location Address
300 EXECUTIVE CENTER DR WEST PALM BEACH, FL 33401
Location Phone
(561) 201-3234
Mailing Address
2784 SW 129TH TER MIRAMAR, FL 33027
Mailing Phone
(561) 201-3234
Medical School Name
OTHER
Graduation Year
2006
Is Sole Proprietor?
Yes
Enumeration Date
11-12-2010
Last Update Date
01-05-2022
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Wallace Thomas is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program and the following quality measures were reported: advance care planning, care plan, implementation of medication management practice improvements, measurement and improvement at the practice and panel level and participation in an ahrq-listed patient safety organization.. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

The typical physician office visit costs for Medicare beneficiaries in this area are: $35.38 for a new patient copayment and $27.09 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Hospitalist

Taxonomy Code
208M00000X
Type
Allopathic & Osteopathic Physicians
License No.
ME126338
License State
FL
Taxonomy Description
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

ME126338 (FL)
2208M00000XAllopathic & Osteopathic Physicians

Hospitalist

ME126338 (AL)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Cross and Blue Shield of Texas

    • Blue Advantage Bronze HMO℠ 204 - HMO
    • Blue Advantage Bronze HMO℠ 301 - HMO
    • Blue Advantage Bronze HMO℠ 302 - HMO
    • Blue Advantage Bronze HMO℠ 707 - HMO
    • Blue Advantage Gold HMO℠ 206 - HMO
    • Blue Advantage Gold HMO℠ 603 - HMO
    • Blue Advantage Gold HMO℠ 706 - HMO
    • Blue Advantage Plus Bronze℠ 303 - POS
    • Blue Advantage Plus Bronze℠ 305 - POS
    • Blue Advantage Plus Bronze℠ 707 - POS
  • Cigna Healthcare

    • Connect Bronze 0 Indiv Med Deductible - EPO
    • Connect Bronze 5500 Indiv Med Deductible - EPO
    • Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - EPO
    • Connect Bronze 8500 Indiv Med Deductible - EPO
    • Connect Bronze CMS Standard - EPO
    • Connect Gold 2500 Indiv Med Deductible - EPO
    • Connect Gold 500 Indiv Med Deductible - EPO
    • Connect Gold CMS Standard - EPO
    • Connect Silver 3000 Indiv Med Deductible - EPO
    • Connect Silver 4000 Indiv Med Deductible - EPO
  • Molina Healthcare

    • Bronze 4 - HMO
    • Bronze 8 - HMO
    • Gold 1 - HMO
    • Gold 1 with Adult Vision Services - HMO
    • Gold 8 - HMO
    • Gold 8 with Rx Copay - HMO
    • Silver 1 - HMO
    • Silver 1 250 - HMO
    • Silver 1 250 with Adult Vision Services - HMO
    • Silver 1 with Adult Vision Services - HMO
  • Oscar Health Plan, Inc.

    • Bronze Classic (Choice) - HMO
    • Bronze Classic 4700 (Choice) - HMO
    • Bronze Classic 4700 (Select) - HMO
    • Bronze Classic PCP Saver Plus Rx Copay (Choice) - HMO
    • Bronze Classic PCP Saver Plus Rx Copay (Select) - HMO
    • Bronze Classic Standard (Choice) - HMO
    • Bronze Classic Standard (Select) - HMO
    • Bronze Elite + PCP Saver Plus (Choice) - HMO
    • Bronze Elite + PCP Saver Plus (Select) - HMO
    • Gold Classic Standard (Choice) - HMO
  • Oscar Insurance Company

    • Bronze Classic - EPO
    • Bronze Classic | MercyOne - EPO
    • Bronze Classic 4700 - EPO
    • Bronze Classic 4700 | MercyOne - EPO
    • Bronze Classic PCP Saver Plus - EPO
    • Bronze Classic PCP Saver Plus | MercyOne - EPO
    • Bronze Classic Standard - EPO
    • Bronze Classic Standard | MercyOne - EPO
    • Bronze Elite + PCP Saver Plus - EPO
    • Bronze Elite + PCP Saver Plus | MercyOne - EPO
  • Oscar Insurance Company of Florida

    • Bronze Classic - EPO
    • Bronze Classic 4700 - EPO
    • Bronze Classic Standard - EPO
    • Bronze Elite + PCP Saver Plus - EPO
    • Bronze Elite + Specialist Saver Plus - EPO
    • Bronze Elite Saver Plus - EPO
    • Gold Classic - EPO
    • Gold Classic Standard - EPO
    • Gold Elite - EPO
    • Gold Elite Saver Plus - EPO
  • Medicare

  • Medicaid


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
018564000MEDICAID (05)FL 

PECOS Enrollment and Medicare Participation Status

Wallace Thomas is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 1052607108

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20161229000763

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Oxygen and supplies (D1C)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    3 DME suppliers used 13 Medicare Claims 13 Services Paid

  • Oxygen and supplies (D1C)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    3 DME suppliers used 14 Medicare Claims 14 Services Paid

  • Wheelchairs (D1D)

    Manual wheelchair accessory, wheel braking system and lock, complete, each (HCPCS:E2228)

    1 DME suppliers used 29 Medicare Claims 58 Services Paid

  • Wheelchairs (D1D)

    Standard wheelchair (HCPCS:K0001)

    1 DME suppliers used 25 Medicare Claims 25 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 33401 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $141.52
  • Minimum New Patient Price $61.36
  • Maximum New Patient Price $187
  • Average New Patient Copayment $35.38
  • Minimum New Patient Copayment $15.34
  • Maximum New Patient Copayment $46.75

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $108.36
  • Minimum Established Patient Price $18.68
  • Maximum Established Patient Price $151.65
  • Average Established Patient Copayment $27.09
  • Minimum Established Patient Copayment $4.67
  • Maximum Established Patient Copayment $37.91

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Advance Care PlanningYesN/A
Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning.
Care Plan 100% 23
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Participation in an AHRQ-listed patient safety organization.YesN/A
Participation in an AHRQ-listed patient safety organization.

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Wallace Thomas is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ADVENTHEALTH DAYTONA BEACH301 MEMORIAL MEDICAL PARKWAY
DAYTONA BEACH, FL 32117
(386) 676-6000Acute Care Hospitals
FLORIDA HOSPITAL FLAGLER60 MEMORIAL MEDICAL PKWY
PALM COAST, FL 32164
(386) 586-2000Acute Care Hospitals
HCA FLORIDA LAWNWOOD HOSPITAL1700 S 23RD ST
FORT PIERCE, FL 34950
(772) 468-4500Acute Care Hospitals
HCA FLORIDA RAULERSON HOSPITAL1796 HWY 441 NORTH
OKEECHOBEE, FL 34972
(863) 763-2151Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1831490432
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
286189046
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 6 + 1 + 8 + 9 + 0 + 4 + 6 + 24 = 68
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 68 = 22

The NPI number 1831490432 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1114923356SA-PG-WEST PALM BEACH LLC
Organization
Skilled Nursing Facility300 EXECUTIVE CENTER DR
WEST PALM BEACH, FL 33401
(561) 471-5566
1619302668PALM GARDEN OF WEST PALM BEACH LLC
Organization
Skilled Nursing Facility300 EXECUTIVE CENTER DR
WEST PALM BEACH, FL 33401
(941) 952-9411
1154642932RENAL CAREPARTNERS OF WEST PALM BEACH LLC
Organization
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)300 EXECUTIVE CENTER DR SUITE 101
WEST PALM BEACH, FL 33401
(305) 512-0014
1801462858W THOMAS MEDICAL LLC
Organization
Internal Medicine300 EXECUTIVE CENTER DR
WEST PALM BEACH, FL 33401
(561) 471-5566

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1831490432, enumerated in the NPI registry as an "individual" on November 12, 2010

The provider is located at 300 Executive Center Dr West Palm Beach, Fl 33401 and the phone number is (561) 201-3234

The provider's speciality is Hospitalist with taxonomy code 208M00000X

The provider has more than 19 years of experience.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Cigna. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of July 02, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $141.52 with an average copayment of $35.38 for new patient appointments. Established patients should expect a typical charge of $108.36 and an average copayment of 27.09. Please review your insurance plan or contact the provider directly to determine your specific costs.

The practitioner is affiliated to the following hospital(s): ADVENTHEALTH DAYTONA BEACH, FLORIDA HOSPITAL FLAGLER, HCA FLORIDA LAWNWOOD HOSPITAL and HCA FLORIDA RAULERSON HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on November 12, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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