Matthew Tristan Wallace, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

PENDING Issued in DC

Practice address

701 Kingston Rd
Baltimore, MD 21212-1939

Phone

(410) 377-7658

NPI assigned

Dec 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Emory University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dell Seton Med Center at the University of TX Hospital, Austin, TX, CCN 450124

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.wallace.1@16041.direct.athenahealth.com
• Direct secure messaging: matthew.wallace.1@8363.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 and National Provider Directory roles.

• Seton Family of Doctors

  • Neurological Surgery Physician
  • Austin, TX
  • NPI 1588997233
  Medicare reassignment Care Compare group NPD
• Seton Family of Doctors

  • Family Medicine Physician
  • Austin, TX
  • NPI 1225644065
  NPD
• Seton Family of Doctors

  • Radiology Clinic/Center
  • Austin, TX
  • NPI 1275290694
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Ascension Seton

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1093810327
  Care Compare affiliation

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

{
    "created_epoch": "1229644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229644800000",
    "number": "1609012731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 KINGSTON RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212121939",
            "telephone_number": "410-377-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 KINGSTON RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212121939",
            "telephone_number": "410-377-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MATTHEW",
        "middle_name": "TRISTAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-19",
        "last_updated": "2008-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "DC",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree Wallace
• Edward Anthony Wallace
• Jerrol B Wallace, CRNA
• Joey Lynn Wallace
• Lula Wallace, CAC-AD
• Nancy Wallace, PHD
• Patrick William Wallace, PT
• Rachael Wallace, LCSW
• Reginald Eugene Wallace Jr., PTA
• Shelli Wallace

• Orthopaedic Surgery Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Orthopaedic Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; 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.