MATTHEW RICHARD WALLACE DNP, APRN, PMHNP-BC
NPI 1902611882
Nurse Practitioner - Psychiatric/Mental Health in Lexington, KY

Active since February 10, 2025PECOS Enrolled
1000 S LIMESTONE, LEXINGTON, KY 40506(859) 562-7371 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 3, 2026, Sep 8, 2025, Aug 9, 2025 and 1 more (4 updates tracked since 2025).

About Matthew Richard Wallace Dnp, Aprn, Pmhnp-bc NPPES

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

MATTHEW RICHARD WALLACE DNP, APRN, PMHNP-BC (NPI 1902611882) is an individual psychiatric/mental health provider in Lexington, Kentucky, licensed in Kentucky (4044992) and active in the NPI registry since February 2025. He is enrolled in Medicare PECOS, maintains a secondary practice location in Lexington, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1902611882
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMATTHEW RICHARD WALLACECredential: DNP, APRN, PMHNP-BC
Location Address1000 S LIMESTONELexington, KY 40506-0007
Mailing Address1000 S LimestoneLexington, KY 40536-0001
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 10, 2025
Last NPPES UpdateMarch 3, 20264 updates tracked since enumeration
NPPES CertifiedMarch 3, 2026
NPI 1902611882 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in KY · 4044992
1000 S LIMESTONE, Lexington, KY 40506

Secondary Practice Location 1

Location 1830 S LimestoneLexington, KY 40536-0582 · Phone (859) 323-2778

Medicare Participation & PECOS Enrollment Status

Matthew Wallace is registered with Medicare but may not accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Matthew Wallace is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 1759857972

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20260415002751

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Maybe

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 40506 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.24
  • Minimum New Patient Price $52.76
  • Maximum New Patient Price $162.27
  • Average New Patient Copayment $20.56
  • Minimum New Patient Copayment $13.19
  • Maximum New Patient Copayment $40.56

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $93.94
  • Minimum Established Patient Price $16.53
  • Maximum Established Patient Price $131.99
  • Average Established Patient Copayment $23.48
  • Minimum Established Patient Copayment $4.13
  • Maximum Established Patient Copayment $32.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
1000 S LIMESTONE
LEXINGTON, KY 40506
Pharmacist
1000 S LIMESTONE
LEXINGTON, KY 40506
Nurse Practitioner (Family)
1000 S LIMESTONE
LEXINGTON, KY 40506
Student in an Organized Health Care Education/Training Program
1000 S LIMESTONE
LEXINGTON, KY 40506
Registered Nurse (Critical Care Medicine)
1000 S LIMESTONE
LEXINGTON, KY 40506
Nurse Practitioner (Acute Care)
1000 S LIMESTONE
LEXINGTON, KY 40506
Physician Assistant
1000 S LIMESTONE
LEXINGTON, KY 40506
Emergency Medicine
1000 S LIMESTONE
LEXINGTON, KY 40506
Nurse Practitioner (Family)
1000 S LIMESTONE
LEXINGTON, KY 40506
Nurse Practitioner (Family)
1000 S LIMESTONE
LEXINGTON, KY 40506
Nurse Practitioner (Acute Care)
1000 S LIMESTONE
LEXINGTON, KY 40506
Nurse Practitioner (Acute Care)
1000 S LIMESTONE
LEXINGTON, KY 40506
Nurse Practitioner (Acute Care)
1000 S LIMESTONE
LEXINGTON, KY 40506
Student in an Organized Health Care Education/Training Program
1000 S LIMESTONE
LEXINGTON, KY 40506
Registered Nurse (Critical Care Medicine)
1000 S LIMESTONE
LEXINGTON, KY 40506
Student in an Organized Health Care Education/Training Program
1000 S LIMESTONE
LEXINGTON, KY 40506
Student in an Organized Health Care Education/Training Program
1000 S LIMESTONE
LEXINGTON, KY 40506
Pharmacist (Oncology)
1000 S LIMESTONE
LEXINGTON, KY 40506
Pharmacist
1000 S LIMESTONE
LEXINGTON, KY 40506
Student in an Organized Health Care Education/Training Program
1000 S LIMESTONE
LEXINGTON, KY 40506

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1902611882, enumerated as an "individual" on February 10, 2025.

The provider is located at 1000 S LIMESTONE LEXINGTON, KY 40506 and the phone number is (859) 562-7371.

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.