Wallace Vascular, LLC.
NPI 1629796941ActiveOrganization· Surgery, Vascular Surgery· Cranberry Township, PA
Surgery, Vascular Surgery in Cranberry Township, Pennsylvania, registered in NPPES in August 2022. The authorized official on file is Justin Robert Wallace, MD, Medical Doctor.
Overview
| NPI | 1629796941 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 22, 2022 |
| Last updated in NPPES | Aug 22, 2022 |
| Certified by provider | Aug 18, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Vascular Surgery Primary | 2086S0129X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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