Matthew K Wallace, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD60144423 Issued in WA

Practice address

212 E Central Ave Ste 140
Spokane, WA 99208-6289

Phone

(509) 465-1300

Fax

(509) 465-1313

NPI assigned

Jan 3, 2006

Last updated

Dec 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA, ID2 enrollments

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 2

Specialty

Orthopedic Surgery

Education

University of Texas Medical School at San Antonio, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Orthopaedic Specialists PSGroup PAC ID 7113811654, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Holy Family Hospital Hospital, Spokane, WA, CCN 500077
• Providence Mount Carmel Hospital Hospital, Colville, WA, CCN 501326
• Newport Community Hospital Hospital, Newport, WA, CCN 501310
• Providence St Joseph Hospital Hospital, Chewelah, WA, CCN 501309

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.wallace.1@16598.direct.athenahealth.com

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.

• Northwest Orthopaedic Specialists PS

  • Orthopaedic Surgery Physician
  • Spokane, WA
  • NPI 1609845825

  ID

  Medicare reassignment Care Compare group NPD
• Northwest Orthopaedic Specialists, P.S.

  • Ambulatory Surgical Clinic/Center
  • Spokane, WA
  • NPI 1265401202

  Orthopaedic Surgery

  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

• Pend Oreille County Public Hospital District No 1

  dba Newport Community Hospital

  • Critical Access Hospital
  • Newport, WA
  • NPI 1780778423
  Care Compare affiliation
• Providence Health & Services - Wa

  dba Providence St Joseph Hospital

  • Critical Access Hospital
  • Chewelah, WA
  • NPI 1750532321
  Care Compare affiliation
• Providence Health & Services - Washington

  dba Providence Mount Carmel Hospital

  • Critical Access Hospital
  • Colville, WA
  • NPI 1003067679
  Care Compare affiliation
• Providence Health & Services - Washington

  dba Providence Holy Family Hospital

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1225289895
  Care Compare affiliation

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1356329114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 5TH AVE STE 400",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042715",
            "telephone_number": "509-344-2663",
            "fax_number": "509-624-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E CENTRAL AVE STE 140",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086289",
            "telephone_number": "509-465-1300",
            "fax_number": "509-465-1313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W 5th Ave Ste 500",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042756",
            "country_code": "US",
            "telephone_number": "509-344-8672",
            "fax_number": "509-747-7838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MATTHEW",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD60144423",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "47815",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2007981",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265453900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Wallace
• Esther Wallace
• Jeffrey Eugene Wallace, LICSW, MSW, CDP, MHP
• Karlen Marie Wallace, PT, DPT
• Mackinze C Wallace, CBT
• Meghan Koren Wallblom, MA, CCC-SLP
• Patricia Wallender
• Patricia Marie Waller, M.ED.
• Margaret Eleacia Wallgren, RDN, CD
• Wendy Wallin, MOTR/L

• Orthopaedic Surgery Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Orthopaedic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.