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

Q: 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.

Q: 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.

Q: 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 5 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 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: August 16, 2026.

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

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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 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

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Medicare Participation & PECOS CMS

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

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.

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)