Nicholas Wallace, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

75714 Issued in WI

Practice address

3016 Barclay Way
Ann Arbor, MI 48105-9464

Phone

(616) 309-3319

NPI assigned

Jun 8, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, IN2 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

Specialty

Orthopedic Surgery

Education

University of Texas Medical School at Houston, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Methodist Hospitals IncGroup PAC ID 9638063894, 131 clinicians

Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospitals Inc Hospital, Gary, IN, CCN 150002
• Community Hospital Hospital, Munster, IN, CCN 150125
• Franciscan Health Rensselaer, Inc Hospital, Rensselaer, IN, CCN 151324

Merit-based Incentive Payment System (MIPS)

Final score

78.64 of 100Reported as group

Quality

56.64

Promoting interoperability

73

Improvement activities

40

Cost

76.72

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nwallace138331@themethodisthospitals.direct-ci.com
• Direct secure messaging: nwallace828633@direct.unitypoint.org

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.

• The Methodist Hospitals, Inc

  • Internal Medicine Physician
  • Gary, IN
  • NPI 1720290349
  Medicare reassignment Care Compare group NPD
• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment NPD
• Chesterton Physical Therapy, Inc.

  • Physical Therapist
  • Chesterton, IN
  • NPI 1467608687
  Care Compare group
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• The Methodist Hospitals, Inc

  • Neurology Physician
  • Gary, IN
  • NPI 1720290588
  NPD
• The Methodist Hospitals, Inc.

  • Orthopaedic Surgery Physician
  • Merrillville, IN
  • NPI 1518295948
  NPD

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

• Franciscan Health Rensselaer, Inc.

  • Critical Access Hospital
  • Rensselaer, IN
  • NPI 1932589173
  Care Compare affiliation
• Munster Medical Research Foundation Inc

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation
• The Methodist Hospitals, Inc

  • General Acute Care Hospital
  • Gary, IN
  • NPI 1467504555
  Care Compare affiliation

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1780033928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 BARCLAY WAY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 BARCLAY WAY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059464",
            "telephone_number": "616-309-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-08",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301110098",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "75714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Allen Walla, RN
• Beth Ilene Wallace, MD
• Julia Wallace, MSW
• Leanne Michelle Wallace, RDH
• Michael Eugene Wallace, MA
• Stacia Wallace
• Sarah Mary Wallett, MD
• Kempland Walley
• Emily Byrnes Walling, M.D.
• Cassaundra Rose Wallington, DO

• Orthopaedic Surgery Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.