JACK RYAN WALTER (MD) – Urology Physician, NPI 1306879366
Urology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
317 UROLOGY in WA
Provider Addresses for JACK RYAN WALTER (MD)
Wenatchee Valley Medical Center, 820, North Chelan Avenue, Wenatchee, Chelan County, Washington, 98801, United States
WENATCHEE, WA 988012028
Phone: (509) 663-8711
Type: Mailing
820 N Chelan Ave
Wenatchee, WA 988012028
Phone: (509) 663-8711
Type: Location
3124 S 19th St Ste C320
Tacoma, WA 984052485
Phone: (253) 301-5100
Type: Location
9040 JACKSON AVE MAMC UROLOGY
TACOMA, WA 98431
Phone: (253) 968-2300
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $2,713.
Total Amount is formed as General ($2,713) + Research ($0) + Ownership ($0) = $2,713.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Laborie Medical Technologies Corp. ($1,250).
Total Amount
$2,713
General + Research + Ownership
Payments
12
Total payment records
General Amount
$2,713
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Laborie Medical Technologies Corp. | $1,250 |
| Valencia Technologies Corporation | $642 |
| EDAP TECHNOMED INC | $201 |
| PROCEPT BioRobotics Corporation | $186 |
| COLOPLAST CORP | $142 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-09-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160928002056 | I | Urology | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 5,462 | 28 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 276 | 203 | $0 |
| 51702 | Simple insertion of temporary bladder tube | 97 | 22 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 96 | 96 | $0 |
| 52000 | Diagnostic exam of bladder and urethra using an endoscope | 74 | 69 | $0 |
Insurance plans in this area (ZIP 98801)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | NC | |
| Physician Assistant | WA | |
| Nurse Practitioner | WA | |
| - | IL | |
| - | WA | |
| U R O L O G Y | WA | |
| G A S T R O E N T E R O L O G Y | WA | |
| Family Practice | PA | |
| - | WA | |
| Physician Assistant | WA |
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