Individual provider Active NPI

Joshua Michael Wallentin-Flores, MD

  • Orthopaedic Surgery Physician
  • Flagstaff, AZ
National Provider Identifier
1669960365
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
73668 Issued in AZ
Practice address
107 E Oak Ave
Flagstaff, AZ 86001-1818
Phone
(928) 779-7880
NPI assigned
Apr 27, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X 31485 MS
Orthopaedic Trauma Physician 207XX0801X 68056 TN
Orthopaedic Surgery Physician 207X00000X 73668 AZ Primary

Addresses

Primary practice location

107 E Oak Ave
Flagstaff, AZ 86001-1818

Mailing address

504 W Fir Ave
Flagstaff, AZ 86001-1309
Phone (928) 853-9293

Other practice location 1

720 Eskenazi Ave Bldg 2nd
Indianapolis, IN 46202-5187
Phone (317) 278-5835

Other practice location 2

1211 Union Ave
Memphis, TN 38104-6638
Phone (901) 759-3274

Other names 1

  • Joshua Michael Wallentin-Flores Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230912000092 TN Practitioner - Orthopedic Surgery 7810242393 Reassigns benefits to 1 organization
I20240715003997 AZ Practitioner - Orthopedic Surgery 7810242393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Indiana University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Arizona Healthcare CorporationGroup PAC ID 3577473362, 391 clinicians

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.85
Promoting interoperability
99
Improvement activities
40
Cost
74.4

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31485MSMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince Aug 15, 2024 Accepting new patients
Northern Arizona Healthcare Corporation Orthopaedic Surgery CurrentSince Aug 15, 2024 Accepting new patients
Flagstaff Medical Center Past Accepting new patients
CC Bpci PLC Orthopaedic Surgery Past Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

107 E Oak Ave
Ste 101
Flagstaff, AZ 86001
Phone (928) 774-1811

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

107 E Oak Ave
Flagstaff, AZ 86001
Phone (928) 779-7880

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 6

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": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1669960365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 W FIR AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011309",
            "telephone_number": "928-853-9293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E OAK AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011818",
            "telephone_number": "928-779-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Eskenazi Ave Bldg 2nd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025187",
            "country_code": "US",
            "telephone_number": "317-278-5835",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1211 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381046638",
            "country_code": "US",
            "telephone_number": "901-759-3274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLENTIN-FLORES",
        "first_name": "JOSHUA",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-27",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "MS",
            "license": "31485",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "TN",
            "license": "68056",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "73668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSHUA",
            "last_name": "WALLENTIN-FLORES",
            "middle_name": "MICHAEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.