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DR. CHARLES THOMAS WALLACK D.P.M. NPI 1265404198


NPI Information

NPI: 1265404198
Provider Name: DR. CHARLES THOMAS WALLACK, D.P.M.
Classification: Podiatrist - 213E00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
10 CHAPEL HILL RD
LINCOLN PARK, NJ
ZIP 07035
Phone: (973) 694-5632
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DR. Charles Thomas Wallack, D.P.M. is a podiatrist in Lincoln Park, NJ with 42 years of experience. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. DR. Charles Thomas Wallack, D.P.M. NPI is 1265404198. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduation Year:1982

The provider's business location address is:

10 CHAPEL HILL RD
LINCOLN PARK, NJ
ZIP 07035-719
Phone: (973) 694-5632

The NPI 1265404198 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of tissue from 1 to 5 finger or toe nails (HCPCS:11720)
  • Removal of tissue from 6 or more finger or toe nails (HCPCS:11721)
  • Removal of single thickened skin growth (HCPCS:11055)
  • Removal of 2 to 4 thickened skin growths (HCPCS:11056)

The enumeration date for this NPI number is 2/4/2006 and was last updated on 1/14/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0131XPodiatristFoot Surgery25MD00140200NEW JERSEYNo
2213E00000XPodiatrist25MD00140200NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P3601404OTHERNEW JERSEYOXFORD
2T45204MEDICARE UPINNEW JERSEY
30988130001MEDICARE NSC
40103711000OTHERNEW JERSEYAMERIHEALTH
51376004-01MEDICAIDNEW JERSEY
6WA451495MEDICARE ID-TYPE UNSPECIFIEDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.