Stephen J Wallace MD PC
NPI 1063176352ActiveOrganization· Orthopaedic Surgery, Orthopaedic Trauma· Lake Oswego, OR
Orthopaedic Surgery, Orthopaedic Trauma in Lake Oswego, Oregon, registered in NPPES in October 2021. The authorized official on file is Stephen J. Wallace, MD, Md. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1063176352 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 24, 2021 |
| Last updated in NPPES | Oct 1, 2026 |
| Certified by provider | Oct 1, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Orthopaedic Surgery, Orthopaedic Trauma Primary | 207XX0801X | — | — |
| Orthopaedic Surgery | 207X00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OR) |
|---|
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