Jamie Elise Wallach, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G79903 Issued in CA

Practice address

1332 Park St Ste 202
Alameda, CA 94501-4545

Phone

(510) 523-3417

Fax

(510) 521-1659

NPI assigned

Feb 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Pediatric Medicine

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Consumer Health Advocacy, Inc.

  • Community Health Worker
  • Cambridge, MA
  • NPI 1821889924

  CA

  Medicare reassignment NPD
• East Bay Partners PC

  • Case Manager/Care Coordinator
  • Cambridge, MA
  • NPI 1730060146

  CA

  Medicare reassignment NPD
• Bay Area Committed to Kids Medical Group, Inc.

  • Pediatrics Physician
  • Oakland, CA
  • NPI 1912186834
  NPD (past) Authorized official

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1154465672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 PARK ST STE 202",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014545",
            "telephone_number": "510-523-3417",
            "fax_number": "510-521-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 PARK ST STE 202",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014545",
            "telephone_number": "510-523-3417",
            "fax_number": "510-521-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "JAMIE",
        "middle_name": "ELISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080B0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Obesity Medicine",
            "state": "CA",
            "license": "G79903",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G79903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912186834",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaina Walker
• Georganne Walker, P.N.P.
• Shanique Elizabeth Walker, LCSW
• Lashonda M Wallace
• Tim Wallace
• Emily Louise-Paula Walters, MSW CANDIDATE
• Carlton Louis Walton
• Julie Yafei Wang, LAC
• Lan Wang, ACUPUNCTURIST
• Weiying Wang

• Pediatrics Physician in Alameda, CA
• Providers in Alameda, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.