STEPHEN J WALLACE MD
NPI 1396162673
Orthopaedic Surgery - Orthopaedic Trauma in Lake Oswego, OR

Q: What is Stephen Wallace's NPI number?

The NPI number for Stephen Wallace is 1396162673. It was assigned to this individual provider in the NPPES registry on March 24, 2014.

Q: What is Stephen Wallace's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Stephen Wallace was last updated on January 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.

Active since March 24, 2014PECOS EnrolledAccepts Medicare Assignment

4103 MERCANTILE DR, LAKE OSWEGO, OR 97035(503) 850-9940(503) 850-6709 Get Directions Write a Review

NPPES record last updated: January 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 8, 2026, Oct 24, 2021, Apr 9, 2021 and 1 more (4 updates tracked since 2019).

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About Stephen J Wallace Md NPPES

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

STEPHEN J WALLACE MD (NPI 1396162673) is an individual orthopaedic trauma provider in Lake Oswego, Oregon, licensed in Oregon (MD206048) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS, is affiliated with Legacy Emanuel Medical Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1396162673

Entity TypeIndividualMale

Primary Taxonomy207XX0801X

Provider Legal NameSTEPHEN J WALLACECredential: MD

Location Address4103 MERCANTILE DRLake Oswego, OR 97035-2556

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

Phone(503) 850-9940

Fax(503) 850-6709

Sole ProprietorNo

Medical School CMSBaylor College Of MedicineGraduated 2014

Enumeration DateMarch 24, 2014

Last NPPES UpdateJanuary 8, 20264 updates tracked since enumeration

NPPES CertifiedJanuary 8, 2026

✔ NPI 1396162673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic TraumaAllopathic & Osteopathic Physicians

Taxonomy Code207XX0801X

Licenses✔ Licensed in OR · MD206048✔ Licensed in WA · MD60932486

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 · License MD206048 (OR), MD60932486 (WA)

4103 MERCANTILE DR, Lake Oswego, OR 97035

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Secondary Practice Locations 3

Location 1325 9th AveSeattle, WA 98104 · Phone (206) 520-5000

Location 22160 S 1st AveMaywood, IL 60153-3328 · Phone (708) 216-3280

Location 3535 E 70th StNew York, NY 10021-4823 · Phone (212) 606-1000

Other Identifiers 1

Medicaid1396162673WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stephen J Wallace Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931402864

PECOS Enrollment IDI20211122002255

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

17 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Legacy Emanuel Medical Center

Acute Care Hospitals · Portland, OR

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380007

Location2801 N Gantenbein AvenuePortland, OR 97227 · Multnomah County

Emergency services Birthing friendly

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS AMANDA MAGDALENA KINDER FNP-C

Nurse Practitioner (Family)