Jared John Wallen, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME131777 Issued in FL

Practice address

938 Oakfield Dr
Brandon, FL 33511-4950

Phone

(813) 278-8850

Fax

(813) 820-3508

NPI assigned

Mar 27, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, SD, CA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Merit-based Incentive Payment System (MIPS)

Final score

77.23 of 100Reported as group

Quality

36.36

Promoting interoperability

100

Improvement activities

40

Cost

71.06

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Hospital Physician Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256
  Medicare reassignment NPD
• Monument Health Rapid City Hospital, Inc

  • Multi-Specialty Clinic/Center
  • Rapid City, SD
  • NPI 1275553463
  Medicare reassignment NPD
• Orohealth Corporation a Non Profit Healthcare System

  • Family Medicine Physician
  • Oroville, CA
  • NPI 1013933167
  Medicare reassignment NPD
• Reedley Community Hospital

  • General Acute Care Hospital
  • Reedley, CA
  • NPI 1336167550
  Medicare reassignment NPD
• You & Wee LLC

  • Urology Physician
  • Sarasota, FL
  • NPI 1396338786
  NPD Authorized official
• Monument Health Rapid City Hospital Inc

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1215727854
  NPD
• Monument Health Rapid City Hospital, Inc.

  • Multi-Specialty Clinic/Center
  • Rapid City, SD
  • NPI 1871972794
  NPD
• Reedley Community Hospital

  • Rural Health Clinic/Center
  • Earlimart, CA
  • NPI 1821699620
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1144596974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114950",
            "telephone_number": "813-278-8850",
            "fax_number": "813-820-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114950",
            "telephone_number": "813-278-8850",
            "fax_number": "813-820-3508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Hickory St",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013224",
            "country_code": "US",
            "telephone_number": "321-434-1771",
            "fax_number": "321-434-1775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLEN",
        "first_name": "JARED",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-27",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME131777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120075300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Walker
• Amanda Denise Wallace, NP
• Aster Wallace, RBT
• Johntavia Wallace
• Raychelle Sheryl Wallace
• Rebecca Wallington
• Carey J Walls IV
• Darlene Walsh
• Kelly Walsh, LPTA
• Darrell Ray Walter, O.D.

• Urology Physician in Brandon, FL
• Providers in Brandon, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.