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Active NPI 1801391438 Individual Practitioner Male Practitioner

Dr. Giacomo Colver Waller , MD

Surgery • Ny, NY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Giacomo Waller, MD is a certified Surgery practicing in Ny, NY. With approximately 8 years of clinical experience since graduating from Emory University School Of Medicine in 2018, Dr. Waller delivers high-quality medical care to the local community at 19 E 98TH ST, 7TH FL.

Dr. Waller is affiliated with Icahn School Of Medicine At Mount Sinai and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

19 E 98th St, 7th Fl
Ste A, Box #1259

Ny, NY 100296574

Telephone 2122410949
Fax 2125342654

Medicare Profile & Education

Medical School

Emory University School Of Medicine

Graduation Year

2018

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Ny, NY

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
8 Yrs Matches City Avg
City Avg: 8.0 Yrs
State Avg: 27.8 Yrs
Regional Practice Density
2 Specialists

Practicing in Ny, NY (2269 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Waller (8 Years) 8 Yrs
Ny Specialty Average (8.0 Years) 8.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2023-07-23
Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License NY 322610

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.

Surgery

NUCC Taxonomy Code: 208600000X

State License IL 125.077143

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

State License IL 125.077143

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Illinoise Dfpr
125.077143 (IL)
Commercial Insurance / Payer ID New York State Education Department Office Of The Professions
322610 (NY)

Hospital & Practice Group Affiliations

Icahn School Of Medicine At Mount Sinai

7901 Broadway, Elmhurst, NY 113731329

Secondary Practice Locations

2160 S 1st Ave Ste 2840

Maywood, IL 601533328

Phone: 7082164533

1364 Clifton Rd Ne Ste H100

Atlanta, GA 303221059

Phone: 4047270093

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

26 Associated Practitioners
Dr. Harvey Himel , MD

Plastic Surgery

NPI 1093781742

Doctor of Medicine (M.D.)

Dr. Peter Midulla , MD

Surgery - Pediatric Surgery

NPI 1104892488

Doctor of Medicine (M.D.)

Dr. Jess Ting , MD

Plastic Surgery

NPI 1124094917

Doctor of Medicine (M.D.)

NPI 1124911235
NPI 1154398568

Doctor of Medicine (M.D.)

NPI 1184658874

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location May 21, 2023

Registered at 19 E 98TH ST, 7TH FL, STE A, BOX #1259, NY, NY 100296574 (Tel: 2122410949)

📍
Updated Business Mailing Address May 21, 2023

Registered at 19 E 98TH ST, 7TH FL, STE A, BOX #1259, NY, NY 100296574 (Tel: 2122410949)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 25, 2021

Surgery (License #125.077143 in IL)

📍
Updated Practice Location June 23, 2020

Registered at 2160 S 1ST AVE STE 2840, MAYWOOD, IL 601533328 (Tel: 7082164533)

📍
Updated Business Mailing Address June 23, 2020

Registered at 2160 S 1ST AVE STE 2840, MAYWOOD, IL 601533328 (Tel: 7082164533)

NPI Profile Active April 01, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location April 01, 2018

Registered at 1364 CLIFTON RD NE STE H100, ATLANTA, GA 303221059 (Tel: 4047270093)

📍
Updated Business Mailing Address April 01, 2018

Registered at 1364 CLIFTON RD NE STE H100, ATLANTA, GA 303221059 (Tel: 4047270093)

👤
Provider Name / Credentials Updated April 01, 2018

Recorded as GIACOMO WALLER, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 01, 2018

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 26, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1801391438
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 26, 2018
Last Update: July 23, 2023
Sole Proprietor: No

Mailing Address

19 E 98th St, 7th Fl, Ste A, Box #1259

Ny, NY 100296574

Phone: 2122410949

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.