Individual provider Active NPI

Thomas J Wall, MD

  • Orthopaedic Surgery Physician
  • Scottsdale, AZ
National Provider Identifier
1255366290
Registry record updated Dec 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
24251 Issued in AZ
Practice address
9475 E Ironwood Square Dr Ste 100
Scottsdale, AZ 85258-4576
Phone
(480) 778-1400
Fax
(480) 778-0400
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X 24251 AZ Primary

Addresses

Primary practice location

9475 E Ironwood Square Dr Ste 100
Scottsdale, AZ 85258-4576

Mailing address

9475 E Ironwood Square Dr Ste 100
Scottsdale, AZ 85258-4576
Phone (480) 778-1400

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
I20051109000324 AZ Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 1951329804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Temple University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9475 E Ironwood Square Dr
Suite 100
Scottsdale, AZ 85258-4576
Phone (480) 778-1400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24251AZMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic Institute of Medicine LTD Single Specialty CurrentSince Sep 15, 1998 Accepting new patients

Locations

9393 N 90th St
#102164
Scottsdale, AZ 85258
Phone (480) 778-1400

9475 E Ironwood Square Dr
Ste 100
Scottsdale, AZ 85258
Phone (480) 778-1400

Interoperability endpoints

  • Direct secure messaging: thomas.wall.1@15400.direct.athenahealth.com
  • Direct secure messaging: twall@direct.uspi.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514505600000",
    "number": "1255366290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9475 E IRONWOOD SQUARE DR STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584576",
            "telephone_number": "480-778-1400",
            "fax_number": "480-778-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9475 E IRONWOOD SQUARE DR STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584576",
            "telephone_number": "480-778-1400",
            "fax_number": "480-778-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "24251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.