Wallace Tarry, MD
NPI 1205804945 · Vascular Surgery Physician · Mooresville, NC
Enrolled with Medicare as Practitioner - Vascular Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Wallace Tarry, MD is a Vascular Surgery Physician provider in Mooresville, NC (NPI 1205804945).
Provider details
- NPI number
- 1205804945
- Entity type
- Individual
- Primary specialty
- Vascular Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 200200613 (NC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
20 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
5 documented practice locations
- Medicare service volume (vs. specialty peers)25% of score
818 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With High Level of Medical Decision Making, If Using Time, 40 Minutes Or More99215 | 298 | $174 |
| New Patient Office Or Other Outpatient Visit With a High Level of Medical Decision Making, If Using Time, 60 Minutes Or More99205 | 107 | $211 |
| Visit Complexity Inherent to Evaluation and Management Associated With Medical Care Services That Serve As the Continuing Focal Point for All Needed Health Care Services And/Or With Medical Care Services That Are Part of Ongoing Care Related to a Patient'SG2211 | 100 | $16 |
| Ultrasound of Both Sides of Head and Neck Blood Flow93880 | 80 | $177 |
| Ultrasound Study of Arm and Leg Arteries93922 | 73 | $62 |
| Insertion of Needle And/Or Tube Into Hemodialysis Circuit and Balloon Dilation of Dialysis Segment With Review By Radiologist |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 7 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Clopidogrel Bisulfatebrand: Clopidogrel | 100 | 29 |
| Cilostazol | 50 | 17 |
| Hydrocodone/Acetaminophenbrand: Hydrocodone-Acetaminophen | 33 | 31 |
| Rivaroxabanbrand: Xarelto | 20 | — |
| Atorvastatin Calcium | 18 | — |
| Apixabanbrand: Eliquis | 14 |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$312 across 4 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Additional practice locations (4)
- 1237 Harding PlSte 3100Charlotte, NC 28204Phone: (704) 373-0212
- 101 E W T Harris BlvdSte 1213Charlotte, NC 28262-3485Phone: (704) 863-1950
- 447 Mcalister RdSte 3200Lincolnton, NC 28092-4114Phone: (980) 212-6300
- 134 Medical Park RdSte 111 - Adult CardiologyMooresville, NC 28117-8526Phone: (704) 801-9100
Registry dates
- Enumerated
- 2006-03-09
- Last updated
- 2024-07-16
Frequently asked questions
- What is Wallace Tarry's NPI number?
- Wallace Tarry's National Provider Identifier (NPI) is 1205804945, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Wallace Tarry's specialty?
- Wallace Tarry is listed in the NPPES registry with a primary specialty of Vascular Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Wallace Tarry located?
- Wallace Tarry's practice location on file with NPPES is 146 Medical Park Rd, Mooresville, NC 28117-8528.
- What is Wallace Tarry's phone number?
- The practice phone number listed in the NPPES registry for Wallace Tarry is (704) 799-3939.
- Does Wallace Tarry accept Medicare?
- Wallace Tarry is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Wallace Tarry's NPI active?
- Yes — Wallace Tarry's NPI (1205804945) is active in the NPPES registry as of the last update on 2024-07-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.