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PHILLIP G WALTON M.D.
NPI 1770710204
Orthopaedic Surgery in Lawrenceville, GA

Active since June 11, 2009PECOS EnrolledAccepts Medicare Assignment
92.93/100
CMS Quality Rating
758 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30046(770) 962-4300(770) 339-7544 Get Directions Write a Review

NPPES record last updated: October 26, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Phillip G Walton M.d. NPPES

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

PHILLIP G WALTON M.D. (NPI 1770710204) is an individual orthopaedic surgery provider in Lawrenceville, Georgia, licensed in Georgia (074128) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Gwinnett, and is a graduate of Meharry Medical College School Of Medicine (2009).

NPPES Registry Identity

NPI1770710204
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NamePHILLIP G WALTONCredential: M.D.
Location Address758 OLD NORCROSS RD, SUITE 100Lawrenceville, GA 30046-3385
Mailing Address758 Old Norcross Rd, Suite 100Lawrenceville, GA 30046-3385 · (770) 962-4300 · Fax (770) 339-7544
Phone(770) 962-4300
Fax(770) 339-7544
Sole ProprietorNo
Medical School CMSMeharry Medical College School Of MedicineGraduated 2009
Enumeration DateJune 11, 2009
Last NPPES UpdateOctober 26, 2015
✔ NPI 1770710204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Licenses✔ Licensed in GA · 074128✔ Licensed in MA · L-241198
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
758 OLD NORCROSS RD, Lawrenceville, GA 30046
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Other Identifiers 3

Medicaid003168121AGA
Medicaid003168121BGA
Medicare PIN20220I5251GA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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

Phillip G Walton M.d. 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 ID2668630369
PECOS Enrollment IDI20150728006375
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 10

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.

X-ray of foot, minimum of 3 views 73630
An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.
281 services174 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
220 services135 patients
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.
165 services151 patients
X-ray of ankle, 2 views 73600
An X-ray of the ankle, 2 views, is a quick, painless test that produces images of the bones and joints in your ankle. Two different angles are used to provide a more complete picture. It helps detect fractures, sprains, arthritis, or other abnormalities. It's safe and typically takes only a few minutes.
54 services45 patients
X-ray of ankle, minimum of 3 views 73610
An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.
49 services37 patients
Fluoroscopic guidance for needle placement 77002
Fluoroscopic guidance for needle placement is a medical procedure that uses a special X-ray technology to help accurately place a needle in the body. It's often used in biopsies, injections or other treatments to ensure precision and safety.
41 services34 patients

Hospital Affiliations CMS Care Compare

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

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110087
Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30046 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
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.

92.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.38
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
9%783 patients1/55-star benchmark: 95%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
81%3,994 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%1,484 patients4/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
0%418 patients1/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
50%119 patients3/55-star benchmark: 88%
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.
87%884 patients2/55-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.
26%1,749 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…
16%1,650 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 92% · 803 patients
Patients tobacco: 9% · 43 patients
86%803 patients4/55-star benchmark: 98%
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…
87%1,749 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…
15%1,749 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.
49%1,749 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

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

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361
DME-Orthotic Devices · category DF003N
1 supplier12 claims12 services$189.90 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 20

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

DR. RAYMOND C. HUI M.D.
Orthopaedic Surgery
758 OLD NORCROSS RD, SUITE 100
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 962-4300
JESSICA GLADDEN OT
Occupational Therapist
758 OLD NORCROSS RD, SUITE 110
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 985-7190
KALI DANIELLE ARNOLD MD
Orthopaedic Surgery
758 OLD NORCROSS RD, SUITE 100
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 962-4300
HARTLEY L. FALBAUM M.D.
Orthopaedic Surgery
758 OLD NORCROSS RD, SUITE 100
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 962-4300
MISS TAMBURAI DOMBO PT
Physical Therapist
758 OLD NORCROSS RD, SUITE 110
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 985-7190
SUSAN L FLEMING NP
Nurse Practitioner (Adult Health)
758 OLD NORCROSS RD, SUITE 100
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 962-4300
EMILIA MORRIS PA
Physician Assistant
758 OLD NORCROSS RD, SUITE 100
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 962-4300
SATYA P KARAMCHANDANI MPT
Physical Therapist
758 OLD NORCROSS RD, SUITE 110
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 985-7190

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 Phillip Walton's NPI number?

The NPI number for Phillip Walton is 1770710204. It was assigned to this individual provider in the NPPES registry on June 11, 2009.

Where is Phillip Walton located?

Phillip Walton practices at 758 Old Norcross Rd Suite 100, Lawrenceville, GA 30046. The listed phone number is (770) 962-4300.

What is Phillip Walton's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Phillip Walton enrolled in Medicare?

Yes. Phillip Walton 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 Phillip Walton accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Phillip Walton 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 Phillip Walton affiliated with any hospitals?

According to CMS data, Phillip Walton is affiliated with Northside Hospital Gwinnett.

When was this NPI record last updated?

The NPPES record for Phillip Walton was last updated on October 26, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.