MR. MARK W WALTER (M.D) – Psychiatry Physician, NPI 1205910643

MR. MARK W WALTER (M.D) is a healthcare provider. based in Gillette, Wyoming. specializing in PSYCHIATRY. They hold the professional credentials M.D. They hold a License No. MD-48932 (IA). The NPI Number for MR. MARK W WALTER (M.D) is 1205910643

Main info

Male
24 Years Of Experience
Name
MR. MARK W WALTER (M.D)
NPI
1205910643
Phone
(307) 688-5000
Address
501 S Burma Ave
Enumeration Date
24 October 2006
Last Update Date
23 January 2025

Doctor Profile

Medical School Name
WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
2002 (24 years ago)
PAC ID
6103858477
Group Practice PAC ID
0345343158
Professional Enrollment ID
I20231107001579
Address ID
IA520013679Du1690XSTXX301

Contacts

Secure Messaging
cchwyo@cchwyo.sdhealthlink.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience80
Completeness85
Years active:19State licenses:3Other namesUpdated within 12 months

42 PSYCHIATRY in WY

Provider Addresses for MR. MARK W WALTER (M.D)

  • 501 S Burma Ave

    Gillette, WY 827163426

    Phone: (307) 688-5000

    Fax: (307) 688-5074

    Type: Location

  • 1690 ELM ST STE 300

    DUBUQUE, IA 520013679

    Phone: (563) 690-2850

    Fax: (563) 582-5335

    Type: Location

  • Gillette Post Office, 311, South Kendrick Avenue, Gillette, Campbell County, Wyoming, 82716, United States

    GILLETTE, WY 827173011

    Phone: (307) 688-5000

    Fax: (307) 688-5074

    Type: Mailing

  • Campbell County Health, 501, South Burma Avenue, Gillette, Campbell County, Wyoming, 82716, United States

    GILLETTE, WY 827163426

    Phone: (307) 688-5000

    Fax: (307) 688-5074

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-11-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 6 Medicare enrollment records; no due dates published yet.

Enrollment records

6

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20081031000047IPsychiatryWYTBD
I20220719002833IPsychiatryNDTBD
I20221007001256IPsychiatryMTTBD
I20230802002584IPsychiatryWITBD
I20230816002379IPsychiatryIATBD
I20231107001579IPsychiatryMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes1611$0
View full utilization report →

Insurance plans in this area (ZIP 82716)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345343158View full group profile
NameSpecialtyState
Clinical Social WorkerIA
Nurse PractitionerIA
-IA
Nurse PractitionerWI
Nurse PractitionerIA
P S Y C H I A T R YIL
Internal MedicineIA
O B S T E T R I C S/ G Y N E C O L O G YIA
Nurse PractitionerIA
-IA

Reviews

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Frequently asked questions

How do I look up MR. MARK W WALTER (M.D) by NPI?
Use NPI 1205910643 when you need to reference MR. MARK W WALTER (M.D) in forms, claims, or directories.
Is MR. MARK W WALTER (M.D) active in the national directory?
MR. MARK W WALTER (M.D)'s public NPI profile is in an active state.
What field does MR. MARK W WALTER (M.D) work in?
You can think of MR. MARK W WALTER (M.D) as practicing within Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What location shows for MR. MARK W WALTER (M.D)?
We surface Gillette, Wyoming for MR. MARK W WALTER (M.D) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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