Carl Bradley Wallis, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

18947 Issued in NV

Practice address

10561 Jeffreys St Ste 230
Henderson, NV 89052-4268

Phone

(702) 565-6565

Fax

(702) 565-8898

NPI assigned

Mar 25, 2013

Last updated

Jun 27, 2019By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Orthopedic Surgery

Education

Toledo Medical College, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedic Institute of Henderson LLPGroup PAC ID 0345229423, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Omnia Home Care LLC Home health agency, Mesquite, NV, CCN 297319
• A Plus Home Health Systems, LLC Home health agency, Las Vegas, NV, CCN 297256
• Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045
• West Henderson Hospital Hospital, Henderson, NV, CCN 290062

Merit-based Incentive Payment System (MIPS)

Final score

75.43 of 100Reported as group

Quality

55.74

Promoting interoperability

94

Improvement activities

40

Cost

67.35

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22165/brand/1/csg/1/fhir/r4
• Direct secure messaging: orthoinst@oih.exscribedirect.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.

• Orthopaedic Institute of Henderson LLP

  • Orthopaedic Surgery Physician
  • Henderson, NV
  • NPI 1447269014
  Medicare reassignment Care Compare group NPD

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

• A Plus Home Health Systems LLC

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1154824985
  Care Compare affiliation
• Dignity Health

  dba St. Rose Dominican Hospital, Siena Campus

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1770626426
  Care Compare affiliation
• Omnia Home Care, LLC

  • Home Health Agency
  • Mesquite, NV
  • NPI 1679179550
  Care Compare affiliation
• West Henderson Hospital Medical Center LLC

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1962181172
  Care Compare affiliation

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1396087623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10561 JEFFREYS ST STE 230",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524268",
            "telephone_number": "702-565-6565",
            "fax_number": "702-565-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10561 JEFFREYS ST STE 230",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524268",
            "telephone_number": "702-565-6565",
            "fax_number": "702-565-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "CARL",
        "middle_name": "BRADLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NV",
            "license": "18947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "OrthoInst@OIH.exscribedirect.com",
            "affiliation": "N",
            "address_1": "10561 Jeffreys St Ste 230",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890524268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brooke Melanie Wallace, PA
• Jamie Wallace
• Jennifer M. Wallace, M.ED
• Trevor Wallace
• Barbara Wallen-Adams
• Jermaine Michael Walls, DDS
• Walmart Inc. (Walmart Pharmacy 10-2050)
• Walmart Inc. (Walmart Pharmacy 10-2838)
• Walmart Inc. (Walmart Pharmacy 10-3354)
• Jennifer Lynn Walsh

• Orthopaedic Surgery Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Orthopaedic Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.