DR. MARK S WALLIS M.D.
NPI 1861489049
Dermatology - MOHS-Micrographic Surgery in Longview, TX

Q: What is Mark Wallis's NPI number?

The NPI number for Mark Wallis is 1861489049. It was assigned to this individual provider in the NPPES registry on October 3, 2005.

Q: What is Mark Wallis's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Q: When was this NPI record last updated?

The NPPES record for Mark Wallis was last updated on March 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 03, 2005PECOS EnrolledAccepts Medicare Assignment

88.53/100

CMS Quality Rating

3535 N FOURTH ST STE 400, LONGVIEW, TX 75605(903) 757-3881(903) 757-5948 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 7, 2023, Jul 21, 2021 (2 updates tracked since 2021).

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About Dr. Mark S Wallis M.d. NPPES

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

DR. MARK S WALLIS M.D. (NPI 1861489049) is an individual mohs-micrographic surgery provider in Longview, Texas, licensed in Texas (H6685) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Texas Medical School At San Antonio (1988).

NPPES Registry Identity

NPI1861489049

Entity TypeIndividualMale

Primary Taxonomy207ND0101X

Provider Legal NameDR. MARK S WALLISCredential: M.D.

Location Address3535 N FOURTH ST STE 400Longview, TX 75605-0038

Mailing Address3535 N Fourth St Ste 400Longview, TX 75605-0038 · (903) 757-3881 · Fax (903) 757-5948

Phone(903) 757-3881

Fax(903) 757-5948

Sole ProprietorYes

Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 1988

Enumeration DateOctober 3, 2005

Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration

NPPES CertifiedJuly 21, 2021

✔ NPI 1861489049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

License✔ Licensed in TX · H6685

Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Also ListedDermatologyTaxonomy 207N00000X · License H6685 (TX)

Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X · License H6685 (TX)

Also ListedDermatology · Clinical & Laboratory Dermatological ImmunologyTaxonomy 207NI0002X · License H6685 (TX)

Also ListedDermatology · Pediatric DermatologyTaxonomy 207NP0225X · License H6685 (TX)

Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X · License H6685 (TX)

3535 N FOURTH ST STE 400, Longview, TX 75605

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Other Identifiers 6

Other30076724TX · Dps Number

Other45D0684764TX · Clia Number

OtherCID037095TX · Cidc Number

OtherH6685TX · Medical License Number

Other04813881913TX · Med. Ed. Number

Medicaid0898678-03TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan.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. Mark S Wallis 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 ID7113057563

PECOS Enrollment IDI20100610000658

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 38

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.

Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg J7345

Aminolevulinic acid hcl is a topical gel used to treat certain skin conditions. It works by making affected skin cells more sensitive to light, which is then used to destroy these cells. The gel is applied by a healthcare professional.

5,000 services16 patients

Pathology examination of tissue using a microscope, intermediate complexity 88305

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

2,171 services1,291 patients

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

1,383 services193 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

347 services264 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

317 services223 patients

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks 17311

This procedure involves the careful removal of a growth from the head, neck, hands, or feet. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to study its characteristics and determine the nature of the growth.

270 services204 patients

Cogenex amniotic membrane, per square centimeter Q4229

Cogenex amniotic membrane is a treatment option involving a thin tissue layer. This tissue, derived from the amniotic sac, is applied to areas needing healing or repair. Itâ€™s rich in growth factors and proteins, promoting faster, efficient recovery.

266 services18 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.

197 services148 patients

Pathology examination of tissue using a microscope, moderately low complexity 88304

A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.

156 services136 patients

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks 17312

This procedure involves the careful removal of abnormal growths from the head, neck, hands, or feet. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any irregularities. The process may be carried out in multiple stages for thorough examination.

129 services93 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

114 services99 patients

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm 13132

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.

101 services91 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

72 services18 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

56 services23 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

53 services47 patients

Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm 11301

This procedure involves the careful removal of a small skin growth on the body, arms, or legs. It's done by shaving off the growth that's 0.6-1.0 cm in size. It's a common, safe method to treat non-cancerous skin growths and improve skin appearance.

52 services37 patients

Biopsy of related skin growth, each additional growth 11103

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

49 services26 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

44 services41 patients

Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less 15275

This procedure involves applying a skin substitute graft to a wound that's 25.0 sq cm or less, located on areas such as the face, scalp, eyelids, mouth, neck, ears, around eyes, hands, feet, fingers, or toes. The graft aids in wound healing and tissue regeneration.

43 services23 patients

Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm 11603

This procedure involves the removal of a cancerous skin growth, between 2.1 and 3.0 cm, from the body, arms, or legs. The area is numbed, then the growth is carefully cut out. The goal is to eliminate all cancer cells while minimizing scarring.

35 services30 patients

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm 13121

This is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.

31 services28 patients

Shaving of skin growth of body, arms, or legs, 0.5 cm or less 11300

This is a simple procedure where a small skin growth on your body, arms, or legs, measuring 0.5 cm or less, is carefully shaved off. It's typically quick, with minimal discomfort. It helps to prevent any potential health issues related to the growth.

29 services16 patients

Destruction of precancer skin growth, 15 or more growths 17004

This procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.

27 services23 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm 11311

This procedure involves removing a small skin growth on the face or related areas like the ears, eyelids, nose, lips, or mouth. The growth is gently shaved off, typically under local anesthesia. It's a quick, safe process for growths between 0.6-1.0 cm in size.

24 services21 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less 14060

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

24 services24 patients

Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm 17261

This procedure involves the removal of a cancerous skin growth on the trunk, arms, or legs that is between 0.6 and 1.0 cm in size. The goal is to eliminate the cancerous cells and prevent further spread. The method of destruction may vary, including methods such as surgery, laser, or cryotherapy.

24 services16 patients

Application of light with debridement to destroy precancer skin growth 96574

This procedure involves applying a special light source to the skin after removing dead tissue (debridement). The light helps destroy precancerous growths, preventing them from developing into skin cancer. It's a safe and effective method to keep your skin healthy.

24 services15 patients

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.

23 services23 patients

Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm 13152

This procedure involves repairing a wound on your eyelids, nose, ears, or lip that is between 2.6 and 7.5 cm long. It's considered complicated due to the location and size. The doctor will clean, treat, and stitch the wound to promote healing.

21 services20 patients

Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm 17262

This procedure involves removing a cancerous skin growth on the trunk, arms, or legs that is between 1.1 and 2.0 cm in size. The growth is destroyed using methods like surgery, laser, or freezing, aiming to eliminate cancer and prevent its spread.

21 services19 patients

Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks 17313

This procedure involves the removal of a growth from your trunk, arms, or legs. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to identify any abnormalities. This helps in diagnosing and planning further treatment.

20 services19 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm 12034

This procedure involves the repair of a moderate-sized wound (7.6-12.5 cm) on the scalp, underarms, trunk, arms, or legs. It includes cleaning, removing damaged tissue, and stitching the wound to promote healing. Local anesthesia is used for comfort.

19 services17 patients

Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm 17281

This procedure involves the removal of cancerous skin growths on the face, ears, eyelids, nose, lips, or mouth that are between 0.6-1.0 cm in size. The goal is to eliminate cancer cells, preventing further spread and promoting health.

19 services18 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less 11310

This procedure involves the careful removal of a small skin growth on the face or related areas. A medical professional uses a special tool to gently shave off the growth, which is 0.5 cm or less. It's a common, safe procedure.

18 services18 patients

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm 11306

This procedure involves the careful removal of a small skin growth, between 0.6-1.0 cm in size, from the scalp, neck, hands, or feet. It's done using a special tool to gently shave off the growth, ensuring minimal discomfort.

13 services12 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

13 services11 patients

Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm 12052

This procedure involves repairing a wound on the face, ears, eyelids, nose, lips, or mouth that measures between 2.6-5.0 cm. The process includes cleaning, suturing if necessary, and dressing the wound to promote healing and prevent infection.

12 services12 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75605 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

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.

88.53/100

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

Scored as part of a group practice

Quality

65.1

Promoting Interoperability

100

Improvement Activities

Cost

96.67

Other Providers at the Same Location NPPES 11

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

MR. HEROLD SCOTT OSBORNE P.A-C

Physician Assistant (Medical)