Individual provider Active NPI

Brent Michael Walz, MD

  • Orthopaedic Surgery Physician
  • Jeffersonville, IN
National Provider Identifier
1720078900
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
01060263A Issued in IN
Practice address
1220 Spring St
Jeffersonville, IN 47130-3704
Phone
(812) 282-8494
Fax
(812) 280-3030
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 39291 KY
Orthopaedic Surgery Physician 207X00000X 01060263A IN Primary

Addresses

Primary practice location

1220 Spring St
Jeffersonville, IN 47130-3704

Mailing address

PO Box 776351
Chicago, IL 60677-3704
Phone (502) 559-9337

Other identifiers 5

IdentifierTypeStateIssuer
200354700AMedicaidIN
000000365692OtherININ BC
7100620820MedicaidKY
IN2570009OtherINMEDICARE
1720078900OtherINNPI

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050607000239 IN Practitioner - Orthopedic Surgery 3173566544 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Louisville School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians
New Horizons Physical Therapy Limited PartnershipGroup PAC ID 4183641608, 77 clinicians

Practice addresses (Care Compare)

1461 N Gardner St
Norton Community Medical Associates
Scottsburg, IN 47170-7751
Phone (812) 218-7966

2125 State St
Suite 2
New Albany, IN 47150-4972

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement37
Knee replacement51
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01060263AINMDOrthopaedic Surgery Physician
39291KYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Community Medical Associates, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Community Medical Associates, Inc. Orthopaedic Surgery Past Accepting new patients

Locations

11500 Highway 62
Charlestown, IN 47111
Phone (812) 256-0700

2051 Clevidence Blvd
Clarksville, IN 47129
Phone (812) 280-6650

207 Sparks Ave
Ste 300
Jeffersonvlle, IN 47130
Phone (812) 218-7978

1220 Spring St
Jeffersonvlle, IN 47130
Phone (812) 282-8494

207 Sparks Ave
Ste 301
Jeffersonvlle, IN 47130
Phone (812) 280-5894

1373 E State Road 62
#6F
Madison, IN 47250
Phone (502) 629-7181

3707 Charlestown Rd
Ste C1
New Albany, IN 47150
Phone (812) 944-4720

1461 N Gardner St
Scottsburg, IN 47170
Phone (812) 282-8494

Interoperability endpoints

  • Direct secure messaging: bwalz280575@direct.nortonhealthcare.org

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1720078900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606773704",
            "telephone_number": "502-559-9337",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SPRING ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303704",
            "telephone_number": "812-282-8494",
            "fax_number": "812-280-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALZ",
        "first_name": "BRENT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "39291",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01060263A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200354700A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN BC",
            "identifier": "000000365692",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100620820",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IN2570009",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720078900",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.