Individual provider Active NPI

John Wallace, M.D.

  • Pain Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1225292634
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
52631 Issued in AZ
Practice address
9321 W Thomas Rd Ste 205
Phoenix, AZ 85037-3392
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
Jul 15, 2008
Last updated
Apr 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 4301093046 MI
Anesthesiology Physician 207L00000X 52631 AZ
Pain Medicine Physician 208VP0000X 52631 AZ Primary

Addresses

Primary practice location

9321 W Thomas Rd Ste 205
Phoenix, AZ 85037-3392

Mailing address

1850 N Central Ave Ste 1600
Phoenix, AZ 85004-4633
Phone (602) 262-8900

Other identifiers 1

IdentifierTypeStateIssuer
190894MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161003001633 AZ Practitioner - Anesthesiology 4789834375 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Michigan State University College of Human Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3420 S Mercy Rd
Suite 200
Gilbert, AZ 85297-0423
Phone (866) 974-2673

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.65 of 100Reported as group
Quality
76.23
Promoting interoperability
100
Improvement activities
40
Cost
75.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301093046MIMDAnesthesiology Physician
52631AZMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Education LLC CurrentSince Jan 24, 2018 Accepting new patients
Center for Orthopedic Research and Educatoin Multi-Specialty CurrentSince Jan 24, 2018 Accepting new patients
Valley Anesthesiology Consultants, Inc. Multi-Specialty CurrentSince Sep 19, 2016 Accepting new patients
Center for Orthopedic Research and Education, LLC Multi-Specialty Current Accepting new patients
Central Anesthesia Services, PC Multi-Specialty Past Accepting new patients

Locations

2680 S Val Vista Dr
Ste 146
Gilbert, AZ 85295
Phone (480) 454-7680

3420 S Mercy Rd
Ste 200
Gilbert, AZ 85297
Phone (480) 909-3788

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

1500 S Dobson Rd
Ste 202
Mesa, AZ 85202
Phone (866) 974-2373

18444 N 25th Ave
Ste 210
Phoenix, AZ 85023
Phone (623) 241-8706

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

9321 W Thomas Rd
Ste 205
Phoenix, AZ 85037

8952 E Desert Cove Ave
Ste 113
Scottsdale, AZ 85260
Phone (480) 314-7772

10484 W Thunderbird Blvd
Ste 100
Sun City, AZ 85351
Phone (669) 742-6738

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

10503 W Thunderbird Blvd
Ste 262
Sun City, AZ 85351
Phone (623) 832-5589

13995 W Statler Blvd
Ste 165
Surprise, AZ 85374
Phone (623) 537-5661

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1225292634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044633",
            "telephone_number": "602-262-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9321 W THOMAS RD STE 205",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373392",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301093046",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "52631",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "AZ",
            "license": "52631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190894",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.