Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

STEPHEN J WALLACE MD PC
NPI 1063176352
Orthopaedic Surgery - Orthopaedic Trauma in Lake Oswego, OR

Q: What is Stephen J Wallace MD PC's NPI number?

The NPI number for Stephen J Wallace MD PC is 1063176352. It was assigned to this organization in the NPPES registry on October 24, 2021.

Q: What is Stephen J Wallace MD PC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Trauma, with taxonomy code 207XX0801X.

Active since October 24, 2021

4250 MERCANTILE DR, LAKE OSWEGO, OR 97035(503) 850-9940(503) 850-6709 Get Directions Write a Review

NPPES record last updated: October 1, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 1, 2026, Jan 8, 2026, Oct 24, 2021 (3 updates tracked since 2021).

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About Stephen J Wallace Md Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STEPHEN J WALLACE MD PC (NPI 1063176352) is a healthcare organization registered as an orthopaedic trauma in Lake Oswego, Oregon and active in the NPI registry since October 2021. The organization lists Stephen J Wallace, Md, as its authorized official.

NPPES Registry Identity

NPI1063176352

Entity TypeOrganization

Primary Taxonomy207XX0801X

Legal Business NameSTEPHEN J WALLACE MD PC

Location Address4250 MERCANTILE DRLake Oswego, OR 97035-2504

Mailing Address4103 Mercantile DrLake Oswego, OR 97035-2556 · (503) 850-9940 · Fax (503) 850-6709

Phone(503) 850-9940

Fax(503) 850-6709

Organization SubpartNo

Authorized OfficialStephen J WallaceMd · (270) 556-0604

Enumeration DateOctober 24, 2021

Last NPPES UpdateOctober 1, 20263 updates tracked since enumeration

NPPES CertifiedOctober 1, 2026

✔ NPI 1063176352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic TraumaAllopathic & Osteopathic Physicians

Taxonomy Code207XX0801X

Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis.

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X

4250 MERCANTILE DR, Lake Oswego, OR 97035

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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stephen J Wallace Md Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Stephen J Wallace MD PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Stephen Wallace, MD

Orthopedic Surgery

NPI 1396162673

4250 MERCANTILE DR
Lake Oswego, OR 97035

(503) 850-9940

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stephen J Wallace MD PC's NPI number?

The NPI number for Stephen J Wallace MD PC is 1063176352. It was assigned to this organization in the NPPES registry on October 24, 2021.

Where is Stephen J Wallace MD PC located?

Stephen J Wallace MD PC is located at 4250 Mercantile Dr, Lake Oswego, OR 97035. The listed phone number is (503) 850-9940.

What is Stephen J Wallace MD PC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Trauma, with taxonomy code 207XX0801X.

Is Stephen J Wallace MD PC enrolled in Medicare?

Yes. Stephen J Wallace MD PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Stephen J Wallace MD PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Orthopedic Surgery) reassigns their Medicare billing to Stephen J Wallace MD PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Stephen J Wallace MD PC was last updated on October 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.