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MICHAEL J WALTER MD
NPI 1629096359
Internal Medicine - Critical Care Medicine in Maryville, IL

Active since July 18, 2006PECOS EnrolledAccepts Medicare Assignment
74.42/100
CMS Quality Rating
6812 STATE ROUTE 162 STE 202, MARYVILLE, IL 62062(618) 288-6844(618) 288-6852 Get Directions Write a Review

NPPES record last updated: August 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Michael J Walter Md NPPES

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

MICHAEL J WALTER MD (NPI 1629096359) is an individual critical care medicine provider in Maryville, Illinois, licensed in Missouri (103849) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Anderson Hospital, and maintains a secondary practice location in Bridgeton.

NPPES Registry Identity

NPI1629096359
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameMICHAEL J WALTERCredential: MD
Location Address6812 STATE ROUTE 162 STE 202Maryville, IL 62062-8562
Mailing Address6810 State Route 162, Box 215Maryville, IL 62062 · (618) 391-6495
Phone(618) 288-6844
Fax(618) 288-6852
Sole ProprietorNo
Medical School CMSSaint Louis University School Of MedicineGraduated 1990
Enumeration DateJuly 18, 2006
Last NPPES UpdateAugust 28, 2024
NPPES CertifiedAugust 28, 2024
✔ NPI 1629096359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
License✔ Licensed in MO · 103849
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License 103849 (MO)
6812 STATE ROUTE 162 STE 202, Maryville, IL 62062
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Secondary Practice Location 1

Location 112303 DePaul DrBridgeton, MO 63044 · Phone (314) 344-6000 · Fax (314) 514-6020

Other Identifiers 1

Medicaid208882001MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.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

Michael J Walter 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 ID6305871401
PECOS Enrollment IDI20170824000003
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 9

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
166 services58 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
113 services111 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
111 services109 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
110 services69 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
95 services93 patients
Test for exercise-induced lung stress 94618
An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.
54 services49 patients

Hospital Affiliations CMS Care Compare

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

Anderson Hospital

Acute Care Hospitals · Maryville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140289
Location6800 State Route 162Maryville, IL 62062 · Madison County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62062 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$131.14 typical visit price
range $56.28 – $173.35
Typical copayment $32.78 (range $14.07 – $43.33)
Most-billed visit code 99204
Established Patient
$99.71 typical visit price
range $17.51 – $139.99
Typical copayment $24.92 (range $4.37 – $34.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

74.42/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.31
Promoting Interoperability85
Improvement Activities40
Cost56.92

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%65 patients5/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
5%172 patients1/55-star benchmark: 85%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%279 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
41%310 patients2/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
13%312 patients1/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
95%310 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
2%310 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
9%310 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
2 suppliers11 claims11 services$9.96 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
3 suppliers16 claims83 services$1.45 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
4 suppliers30 claims30 services$14.71 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
4 suppliers69 claims69 services$916.84 avg. paid by Medicare
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470
DME-Other DME · category DE001N
3 suppliers23 claims23 services$74.94 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers17 claims17 services$2.88 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

MIDWEST ACUTE CARE CONSULTANTS PC
Internal Medicine (Pulmonary Disease)
6812 STATE ROUTE 162 STE 202
MARYVILLE, IL 62062
Madison County (618) 288-6844
NATALIE ANN RITZHEIMER PA
Physician Assistant
6812 STATE ROUTE 162 STE 202
MARYVILLE, IL 62062
Madison County (618) 288-6844
RYAN PARKER NP-C
Nurse Practitioner
6812 STATE ROUTE 162 STE 202
MARYVILLE, IL 62062
Madison County (618) 288-6844

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 Michael Walter's NPI number?

The NPI number for Michael Walter is 1629096359. It was assigned to this individual provider in the NPPES registry on July 18, 2006.

Where is Michael Walter located?

Michael Walter practices at 6812 State Route 162 Ste 202, Maryville, IL 62062. The listed phone number is (618) 288-6844.

What is Michael Walter's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Michael Walter enrolled in Medicare?

Yes. Michael Walter is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michael Walter accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Michael Walter as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Michael Walter affiliated with any hospitals?

According to CMS data, Michael Walter is affiliated with Anderson Hospital.

When was this NPI record last updated?

The NPPES record for Michael Walter was last updated on August 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.