NPIMap

Individual provider Active NPI

William Walter Wall, M.D.

  • Orthopaedic Surgery Physician
  • San Jose, CA
National Provider Identifier
1669407342
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G80961 Issued in CA
Practice address
2120 Forest Ave
San Jose, CA 95128-1478
Phone
(408) 297-2012
Fax
(408) 297-2129
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G80961 CA Primary

Addresses

Primary practice location

2120 Forest Ave
San Jose, CA 95128-1478

Mailing address

2120 Forest Ave
San Jose, CA 95128-1478
Phone (408) 297-2012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060308000809 CA Practitioner - Orthopedic Surgery 3173530623 Reassigns benefits to 1 organization
Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Saint Louis University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of Santa ClaraGroup PAC ID 1254244973, 1,000 clinicians

Practice addresses (Care Compare)

2120 Forest Ave
Suite 4
San Jose, CA 95128-1478
Phone (408) 297-2012

751 S Bascom Ave
Santa Clara Vly Med
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

  • Opo Health, LLC Home health agency, San Mateo, CA, CCN 559709
  • Prohealth Home Care, Inc Home health agency, San Jose, CA, CCN 058415
  • Palmeira Home Health Home health agency, San Francisco, CA, CCN 059098
  • Good Samaritan Hospital Hospital, San Jose, CA, CCN 050380
  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

Merit-based Incentive Payment System (MIPS)

Final score
90.23 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
67.45

Merit-based Incentive Payment System (MIPS)

Final score
61 of 100Reported as group
Quality
59.41
Promoting interoperability
0
Improvement activities
40
Cost
71.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement22
Knee replacement34
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jul 1, 2020 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Jul 1, 2020 Accepting new patients
County of Santa Clara Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Locations

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: wwall126085@santaclaravalley.direct-ci.net

Organizations & group practices 5

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 5

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1669407342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 FOREST AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281478",
            "telephone_number": "408-297-2012",
            "fax_number": "408-297-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 FOREST AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281478",
            "telephone_number": "408-297-2012",
            "fax_number": "408-297-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "WILLIAM",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G80961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.