Dr. Jack D Waller , MD
Specialist • Amarillo, TX
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jack Waller has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Jack Waller, MD was a registered Specialist practicing in Amarillo, TX. Throughout an active medical career spanning 17 years, Dr. Waller provided care at the practice location at 1400 S COULTER ST until profile deactivation on 2022-08-15.
Historical Medicare Part B clinical services included destruction of precancer skin growth, 2-14 growths, injection, triamcinolone acetonide, not otherwise specified, 10 mg, destruction of precancer skin growth. Public procedure reimbursement records and service volume details are provided below for historical transparency.
Practice Location & Contact Primary Location
1400 S Coulter St
Amarillo, TX 791061786
Specialty Benchmarks & Practice Insights
Comparative analytics for Specialist in Amarillo, TX
Practicing in Amarillo, TX (2033 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Performed Procedures & Service Volume
Top Medicare Part B procedures performed by this practitioner
| HCPCS Code & Description | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
|
17003
Destruction of precancer skin growth, 2-14 growths
|
183 | 29 | $25.00 | $5.40 |
|
J3301
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
|
96 | 11 | $46.00 | $1.61 |
|
17004
Destruction of precancer skin growth, 15 or more growths
|
48 | 33 | $492.00 | $142.18 |
|
17000
Destruction of skin growth
|
42 | 32 | $126.00 | $62.92 |
|
96372
Injection beneath the skin or into muscle for therapy, diagnosis, or prevention
|
17 | 11 | $62.76 | $16.09 |
Medical Specialties & State Licenses
NUCC Taxonomy Code: 174400000X
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Student in an Organized Health Care Education/Training Program
Doctor of Medicine (M.D.)
Internal Medicine - Pulmonary Disease
Doctor of Medicine (M.D.)
Pediatrics
Doctor of Medicine (M.D.)
Student in an Organized Health Care Education/Training Program
Doctor of Medicine (M.D.)
Student in an Organized Health Care Education/Training Program
Doctor of Medicine (M.D.)
Internal Medicine
Doctor of Medicine (M.D.)
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on August 15, 2022
NPI status registered as active in NPPES database
Registered at 1400 S COULTER ST, AMARILLO, TX 791061786 (Tel: 8063545660)
Registered at 1400 WALLACE BLVD, ATTN: CREDENTIALING DEPT., AMARILLO, TX 791061708 (Tel: 8063545585)
Recorded as JACK WALLER, MD
Specialist
First registered as active Individual Practitioner in NPPES Database.
Patient & Community Reviews
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NPI Administrative Meta
Mailing Address
1400 Wallace Blvd, Attn: Credentialing Dept.
Amarillo, TX 791061708
Phone: 8063545585
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