Active NPI 1023075637 Individual Practitioner Male Practitioner

Dr. Robert D Wallace , MD

Surgery - Plastic and Reconstructive Surgery • Memphis, TN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Robert Wallace, MD is a certified Surgery - Plastic and Reconstructive Surgery practicing in Memphis, TN. With approximately 42 years of clinical experience since graduating from Jefferson Medical College Of Thomas Jefferson University in 1984, Dr. Wallace delivers high-quality medical care to the local community at 1068 CRESTHAVEN RD STE 500.

Dr. Wallace accepts Medicare assignment.

Frequently performed procedures and clinical services include new patient outpatient office visit, established patient outpatient office visit, repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1068 Cresthaven Rd Ste 500

Memphis, TN 38119

Telephone 9018668525

Associated Practice Facility / Clinic

🏢 Ut Mobile Stroke Unit Llc Facility NPI 1346791589

Medicare Profile & Education

Medical School

Jefferson Medical College Of Thomas Jefferson University

Graduation Year

1984

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Plastic and Reconstructive Surgery in Memphis, TN

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

42 Yrs +20.8 yrs vs City Avg

City Avg: 21.2 Yrs

State Avg: 23.0 Yrs

Regional Practice Density

11 Specialists

Practicing in Memphis, TN (78 Statewide)

Telehealth Adoption Rate

9.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

71.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wallace (42 Years) 42 Yrs

Memphis Specialty Average (21.2 Years) 21.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	52	52	$313.25	$101.73
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	38	35	$157.68	$51.49
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	20	19	$2144.21	$603.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	49	49	$300.76	$101.28
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	19	$149.39	$51.89
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	11	11	$2035.09	$580.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$299.06	$97.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$315.62	$105.64
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	21	17	$2990.00	$589.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	29	29	$316.83	$101.83
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	11	$140.00	$42.69
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	11	11	$2990.00	$606.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	39	39	$320.00	$98.82
99213 Established patient office or other outpatient visit, typically 15 minutes	28	23	$220.00	$69.66
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	17	16	$2990.00	$634.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$140.00	$41.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	49	49	$318.12	$100.29
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	20	$140.00	$40.76
99213 Established patient office or other outpatient visit, typically 15 minutes	15	14	$215.07	$68.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	45	33	$127.09	$39.11
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	40	40	$311.77	$94.18
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	20	17	$2922.00	$553.32

Medical Specialties & State Licenses

Surgery - Plastic and Reconstructive Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0122X

State License TN 27658

A surgeon who specializes in plastic and reconstructive surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

130322001 (AR)

Medicaid State Provider ID

00118676 (MS)

Medicaid State Provider ID

3804973 (TN)

Secondary Practice Locations

1910 Nonconnah Blvd, Suite 120

Memphis, TN 381322113

Phone: 9014482300

Practice Associates & Co-Workers

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

14 Associated Practitioners

Dr. Dani Kruchevsky , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1063123016

Doctor of Medicine (M.D.)

Melinda Homa

Physician Assistant - Surgical

NPI 1104569649

Dr. Muntazim Mukit , MD

Plastic Surgery

NPI 1235591371

Doctor of Medicine (M.D.)

Madeleine Jones , PA-C

Physician Assistant - Surgical

NPI 1437035227

Physician Assistant (Certified)

Dr. Mahmoud Hassouba , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1437534682

Doctor of Medicine (M.D.)

Dr. Edward Luce , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1487611000

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

8 Historical Events

📍

Updated Practice Location February 01, 2019

Registered at 1068 CRESTHAVEN RD STE 500, MEMPHIS, TN 38119 (Tel: 9018668525)

📍

Updated Business Mailing Address February 01, 2019

Registered at 1407 UNION AVE STE 700, MEMPHIS, TN 381043641 (Tel: 9018668622)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 1910 NONCONNAH BLVD, SUITE 120, MEMPHIS, TN 381322113 (Tel: 9014482300)

📍

Updated Business Mailing Address July 08, 2007

Registered at 66 N PAULINE ST, SUITE 206, MEMPHIS, TN 381055105 (Tel: 9014487642)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT WALLACE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Surgery (License #27658 in TN)

🟢

Initial NPI Registration & Enumeration April 27, 2006

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: 1023075637

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 27, 2006

Last Update: February 01, 2019

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1407 Union Ave Ste 700

Memphis, TN 381043641

Phone: 9018668622

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.