Individual provider Active NPI

David M Wall, MPA, PA-C

  • Physician Assistant
  • Santa Cruz, CA
National Provider Identifier
1619296548
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20951 Issued in CA
Practice address
1080 Emeline Ave
Santa Cruz, CA 95060-1966
Phone
(831) 454-4100
NPI assigned
May 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA20951 CA Primary

Addresses

Primary practice location

1080 Emeline Ave
Santa Cruz, CA 95060-1966

Mailing address

8053 Valencia St
Aptos, CA 95003-4073
Phone (831) 688-8680

Other practice location 1

8053 Valencia St
Aptos, CA 95003-4073
Phone (831) 688-8680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20100810001152 CA Practitioner - Physician Assistant 2365576535 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa CruzGroup PAC ID 7618872912, shared by 4 NPIs, 65 clinicians

Practice addresses (Care Compare)

1080 Emeline
Santa Cruz, CA 95060-1966

1080 Emeline Ave
Santa Cruz, CA 95060-1966
Phone (831) 454-5401

115 A Coral St
Santa Cruz, CA 95060-2131
Phone (831) 454-2080

1430 Freedom Blvd
Suite D
Watsonville, CA 95076-2752
Phone (831) 763-8400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20951CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Cruz CurrentSince May 27, 2016 Accepting new patients
Cep America - California CurrentSince Aug 1, 2015 Accepting new patients
The Spine Clinic of Monterey Past Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

1080 Emeline Ave
Santa Cruz, CA 95060
Phone (831) 454-4100

1430 Freedom Blvd
Ste D
Watsonville, CA 95076
Phone (831) 763-8400

Interoperability endpoints

  • Direct secure messaging: dwall183533@direct.ochin.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1619296548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8053 VALENCIA ST",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "950034073",
            "telephone_number": "831-688-8680",
            "fax_number": "831-688-8817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601966",
            "telephone_number": "831-454-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8053 Valencia St",
            "address_purpose": "LOCATION",
            "city": "Aptos",
            "state": "CA",
            "postal_code": "950034073",
            "country_code": "US",
            "telephone_number": "831-688-8680",
            "fax_number": "831-688-8817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MPA, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-17",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.