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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: October 18, 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
Phone(859) 562-7371
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
Open in Google Maps ↗

Secondary Practice Location 1

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Matthew Richard Wallace Dnp, Aprn, Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1759857972
PECOS Enrollment IDI20260415002751
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.

Medicare Billing Reassignment

Medicare enrollment records show Matthew Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Kentucky
0.1 mi
Family
UK COLLEGE OF DENTISTRY, 770 ROSE STREET, MN328
Lexington, KY 40536
  • Reassigned Medicare billing, Kentucky enrollment
  • 1,761 clinicians in this Medicare group
NPI 1215449590 (859) 323-3368

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40506 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

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.

CARSON G SWARTZ DNP, APRN
Nurse Practitioner (Acute Care)
1000 S LIMESTONE
LEXINGTON, KY 40506
Fayette County (859) 323-5000
ALEXANDER WILSON MEADOR
Student in an Organized Health Care Education/Training Program
1000 S LIMESTONE
LEXINGTON, KY 40506
Fayette County (859) 257-1000
MRS. LAURA SMITH HUGHES APRN
Nurse Practitioner (Family)
1000 S LIMESTONE
LEXINGTON, KY 40506
Fayette County (859) 323-5901
MEGAN DANIELLE HENSLEY APRN
Nurse Practitioner (Family)
1000 S LIMESTONE
LEXINGTON, KY 40506
Fayette County (859) 323-5901
ASHLEY DANIELLE LUTZ
Student in an Organized Health Care Education/Training Program
1000 S LIMESTONE
LEXINGTON, KY 40506
Fayette County (859) 473-5522
ASHLEY GILLSTRAP APRN
Nurse Practitioner (Acute Care)
1000 S LIMESTONE
LEXINGTON, KY 40506
Fayette County (859) 323-9057
DR. MATTHEW BLACKBURN PHARMD, BCCCP, BCPS
Pharmacist
1000 S LIMESTONE
LEXINGTON, KY 40506
Fayette County (859) 323-2300
MADISON FISCHER
Student in an Organized Health Care Education/Training Program
1000 S LIMESTONE
LEXINGTON, KY 40506
Fayette County (859) 257-1000

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 Matthew Wallace's NPI number?

The NPI number for Matthew Wallace is 1902611882. It was assigned to this individual provider in the NPPES registry on February 10, 2025.

Where is Matthew Wallace located?

Matthew Wallace practices at 1000 S Limestone, Lexington, KY 40506. The listed phone number is (859) 562-7371.

What is Matthew Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Matthew Wallace enrolled in Medicare?

Yes. Matthew Wallace is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Matthew Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Wallace reassigns Medicare benefits to University Of Kentucky (Lexington, KY). The 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 Matthew Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Matthew Wallace was last updated on March 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.