Jeffrey Michael Wallace

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

600 Caisson Hill Rd
Fort Riley, KS 66442-7037

Phone

(785) 239-7000

NPI assigned

Feb 24, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• American Current Care PA

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1811178213

  CO

  Medicare reassignment Care Compare group NPD
• Usacs of Colorado, Inc

  • Emergency Medicine Physician
  • Littleton, CO
  • NPI 1760415871
  Medicare reassignment
• American Current Care P.a.

  • Urgent Care Clinic/Center
  • Beaumont, TX
  • NPI 1376356568
  NPD
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Lakewood, CO
  • NPI 1720614217
  NPD
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Westminster, CO
  • NPI 1790311280
  NPD

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1619392974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CAISSON HILL RD",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "664427037",
            "telephone_number": "785-239-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CAISSON HILL RD",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "664427037",
            "telephone_number": "785-239-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-24",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicola Rose Vogel, MSW, LCSW
• Richard L. Vopat, M.D.
• Alexander C Vos
• Jennifer Elaine Wadeson, LSCSW
• Jeremy Stephen Walker, D.O.
• James Orville Walmann, DDS
• Christopher Warczak, PHARM.D.
• Jessica A Warneke, DO, MPH
• Katrina R Webb, RN
• Charles Brandon Webber, DMD

• Physician Assistant in Fort Riley, KS
• Providers in Fort Riley, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.