Kristian Harold Wall, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

35.131005 Issued in OH

Practice address

6847 N Chestnut St Ste 210
Ravenna, OH 44266-3929

Phone

(330) 297-6060

Fax

(216) 201-7846

NPI assigned

May 4, 2011

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 OH

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

Gastroenterology

Education

Ohio State University College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospitals Portage Medical Center Hospital, Ravenna, OH, CCN 360078

Merit-based Incentive Payment System (MIPS)

Final score

91.15 of 100Reported as apm

Quality

82.31

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwall36865@ehrdirect.uhhospitals.org

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.

• University Primary Care Practices Inc

  • Gastroenterology Physician
  • Mentor, OH
  • NPI 1003935339
  Medicare reassignment Care Compare group NPD
• University Primary Care Practices Inc

  • Emergency Medicine Physician
  • Beachwood, OH
  • NPI 1114227840
  NPD
• University Primary Care Practices Inc

  dba Center for Orthopedics

  • Orthopaedic Surgery Physician
  • Oberlin, OH
  • NPI 1982727087
  NPD
• University Hospitals Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1669499414
  NPD (past)
• University Primary Care Practices

  • Pediatrics Physician
  • Twinsburg, OH
  • NPI 1326166752
  NPD (past)

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

• Robinson Health System, Inc.

  dba University Hospitals Portage Medical Center

  • General Acute Care Hospital
  • Ravenna, OH
  • NPI 1043641897
  Care Compare affiliation

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1669764916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6847 N CHESTNUT ST STE 210",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663929",
            "telephone_number": "330-297-6060",
            "fax_number": "216-201-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6847 N CHESTNUT ST STE 210",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663929",
            "telephone_number": "330-297-6060",
            "fax_number": "216-201-7846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose St",
            "address_2": "Room MN 649",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-4937",
            "fax_number": "859-257-9287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "KRISTIAN",
        "middle_name": "HAROLD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-04",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35.131005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristianwall@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "6847 N Chestnut St Ste 210",
            "city": "Ravenna",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442663929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen Walczak
• Walgreen Co (Walgreens #10784)
• Amanda K Walker, LSW
• Kimberly Kay Walker
• Theodore Laurence Walker, PRSS
• Lolita Lashell Wallace, MED ASST HHA STNA
• Wallis Dialysis LLC (Ravenna Dialysis)
• Deborah Walsh
• James David Walter II, D.O.
• Beth Ann Wanosik

• Gastroenterology Physician in Ravenna, OH
• Providers in Ravenna, OH by specialty
• Gastroenterology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.