Trevor G Wall, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA.0003986 Issued in CO

Practice address

1 Mercado St
Ste 202
Durango, CO 81301-7306

Phone

(970) 247-5362

Fax

(970) 259-6045

NPI assigned

Nov 4, 2013

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 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013

Merit-based Incentive Payment System (MIPS)

Final score

89.06 of 100Reported as group

Quality

89.53

Promoting interoperability

100

Improvement activities

40

Cost

74

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Catholic Health Initiatives Colorado

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Colorado Springs, CO
  • NPI 1356783351
  Medicare reassignment Care Compare group
• Catholic Health Initiatives Colorado

  • Neurology Physician
  • Colorado Springs, CO
  • NPI 1518616515
  NPD
• Catholic Health Initiatives Colorado

  • Orthopaedic Surgery Physician
  • Longmont, CO
  • NPI 1891675294
  NPD
• Catholic Health Initiatives Colorado

  • Neurological Surgery Physician
  • Lakewood, CO
  • NPI 1205846664
  NPD (past)

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

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1083611644
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1588204010
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1679113104
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Aztec, NM
  • NPI 1770123382
  Care Compare affiliation

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1366871972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "STE 202",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017306",
            "telephone_number": "970-247-5362",
            "fax_number": "970-259-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "STE 202",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017306",
            "telephone_number": "970-247-5362",
            "fax_number": "970-259-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "TREVOR",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-04",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2013-0074",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0003986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57729301",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co.
• Dean M. Walker, P.T.
• Michelle Elizabeth Walker, BSN, RN
• Ruby Jo Walker, LCSW,EMDR CERT,CHT,C
• Austin Fisher Wallace, M.D.
• Robert S Wallach, DO
• Walmart Inc.
• Walmart Inc.
• Melissa P Waltigney, CRNFA

• Surgical Physician Assistant in Durango, CO
• Providers in Durango, CO by specialty
• Surgical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; 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.