NPIMap

Individual provider Active NPI

Robert S Wallach, DO

  • Physical Medicine & Rehabilitation Physician
  • Durango, CO
National Provider Identifier
1730247149
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
46615 Issued in CO
Practice address
555 Rivergate LN Ste B1-101
Durango, CO 81301-7470
Phone
(970) 403-3324
Fax
(833) 975-0954
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 46615 CO Primary

Addresses

Primary practice location

555 Rivergate LN Ste B1-101
Durango, CO 81301-7470

Mailing address

555 Rivergate LN Ste B1-101
Durango, CO 81301-7470
Phone (970) 970-4269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20080820000214 CO Practitioner - Physical Medicine and Rehabilitation 5890871057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

555 Rivergate Lane
Suite B1 101
Durango, CO 81301-7470

555 Rivergate LN
Suite B1 101
Durango, CO 81301-7470
Phone (970) 403-3324

Hospital & facility affiliations

  • Animas Surgical Hospital, LLC Hospital, Durango, CO, CCN 060117
  • Southwest Memorial Hospital Hospital, Cortez, CO, CCN 061327
  • Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46615COMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laplata Urological Associates PC Current Accepting new patients
La Plata Physical Medicine PC Physical Medicine & Rehabilitation CurrentSince Jun 15, 2019 Accepting new patients

Locations

555 Rivergate Ln
Ste B1-102
Durango, CO 81301
Phone (970) 259-1971

555 Rivergate Ln
Ste B1-101
Durango, CO 81301
Phone (970) 403-3324

316 Sawyer Dr
Durango, CO 81303
Phone (970) 259-3110

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21595/brand/1/csg/1/fhir/r4
  • Direct secure messaging: robert.wallach.1@21595.direct.athenahealth.com

Organizations & group practices 2

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 11

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1730247149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 RIVERGATE LN STE B1-101",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017470",
            "telephone_number": "970-970-4269",
            "fax_number": "833-975-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 RIVERGATE LN STE B1-101",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017470",
            "telephone_number": "970-403-3324",
            "fax_number": "833-975-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "ROBERT",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "46615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.