Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bradley Wallace, MD

Individual provider Surgery Physician · NPI 1881038115

Bradley Wallace, MD is a General Surgery in Colorado Springs, Colorado. Graduated from University of Texas Southwestern Medical School at Dallas in 2013, 13 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
13
Trained at
University of Texas Southwestern Medical School at Dallas
Licensed in
CO
In the registry since
2013
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1400 E Boulder St Ste 500
Colorado Springs, CO 80909-5533
Phone: (719) 364-6487
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 13001 E. 17th Place, Aurora, CO 80045-2581 — (303) 724-2680

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence DR.0063071 (CO)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1881038115
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 17, 2013
Last updated in NPPESJune 23, 2022
Certification dateJune 23, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduated 2013 (13 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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