Matthew D Wallace, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

023162 Issued in NY

Practice address

HSS Ancillary Services, PC
85 College St
Hamilton, NY 13346

Phone

(315) 824-1252

Fax

(315) 824-8961

NPI assigned

Apr 19, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15149/brand/1/csg/1/fhir/r4

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.

• Orthopedic Center of New England PA

  • Orthopaedic Surgery Physician
  • Portland, ME
  • NPI 1285833236
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1790740074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HSS ANCILLARY SERVICES, PC",
            "address_2": "85 COLLEGE ST",
            "city": "HAMILTON",
            "state": "NY",
            "postal_code": "13346",
            "telephone_number": "315-824-1252",
            "fax_number": "315-824-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HSS ANCILLARY SERVICES, PC",
            "address_2": "85 COLLEGE ST",
            "city": "HAMILTON",
            "state": "NY",
            "postal_code": "13346",
            "telephone_number": "315-824-1252",
            "fax_number": "315-824-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "023162",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Toole
• Loretta Trask, PA
• Christina M. Valencia, FNP
• Francis Walczak IV, PA-C
• James Irwin Wallace, PH.D.
• Pamela West, RD
• Daryl Anders Wilson, NP-C
• Heather Wilson, ATC
• Woodrow Wilson Withers Jr., D.D.S.
• Mary F Yoshino, N.P.

• Physical Therapist in Hamilton, NY
• Providers in Hamilton, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.