NPIMap

Individual provider Active NPI

Jason Eric Wallentine, MD

  • Family Medicine Physician
  • Soldotna, AK
National Provider Identifier
1154884328
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01085823A Issued in IN
Practice address
245 N Binkley St Ste 101
Soldotna, AK 99669-7500
Phone
(907) 714-4111
NPI assigned
Apr 12, 2019
Last updated
Aug 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01085823A IN Primary

Addresses

Primary practice location

245 N Binkley St Ste 101
Soldotna, AK 99669-7500

Mailing address

221 N Celia Ave
Muncie, IN 47303-4609
Phone (765) 747-3141

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwallentine2420576@ak.providencedirect.org Central Peninsula General Hospital Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220826001520 AK Practitioner - Family Practice 9335535129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

245 N Binkley St
Soldotna, AK 99669-7500
Phone (907) 714-4521

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.44 of 100Reported as group
Quality
62.56
Promoting interoperability
81
Improvement activities
40
Cost
67.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions14
Removal of nail tissue1-10
Removal or shaving of skin growth13
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Star Medical Imaging PLLC Current Accepting new patients
Central Peninsula General Hospital, Inc CurrentSince Aug 15, 2022 Accepting new patients
Central Peninsula General Hospital Inc. CurrentSince Aug 15, 2022 Accepting new patients
Central Peninsula General Hospital Inc Past Accepting new patients
Central Peninsula General Hospital, Inc Past Accepting new patients

Locations

245 N Binkley St
Soldotna, AK 99669
Phone (907) 714-4520

245 N Binkley St
Ste 101
Soldotna, AK 99669
Phone (907) 714-4111

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

Interoperability endpoints

  • Direct secure messaging: jwallentine2420576@ak.providencedirect.org

Organizations & group practices 5

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

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1154884328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 N CELIA AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034609",
            "telephone_number": "765-747-3141",
            "fax_number": "765-741-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N BINKLEY ST STE 101",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697500",
            "telephone_number": "907-714-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLENTINE",
        "first_name": "JASON",
        "middle_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01085823A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwallentine2420576@ak.providencedirect.org",
            "affiliation": "Y",
            "endpointDescription": "CPH Direct Messaging Address",
            "affiliationName": "Central Peninsula General Hospital Inc",
            "address_1": "245 N Binkley St Ste 101",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.