Individual provider Active NPI

James W Wallace, MD

  • Pediatric Pulmonology Physician
  • Sioux Falls, SD
National Provider Identifier
1730135070
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
3549 Issued in SD
Practice address
1600 W 22ND St
Sioux Falls, SD 57105-1521
Phone
(605) 312-1000
Fax
(605) 312-1001
NPI assigned
May 26, 2006
Last updated
Mar 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 3549 SD
Pediatrics Physician 208000000X 30538 IA
Pediatric Pulmonology Physician 2080P0214X 3549 SD Primary

Addresses

Primary practice location

1600 W 22ND St
Sioux Falls, SD 57105-1521

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwallace18020@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, ND2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20040805001108 SD Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 0941271456 Reassigns benefits to 2 organizations
I20181228002395 ND Practitioner - Pediatric Medicine 0941271456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Texas Medical School at Houston, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford ClinicGroup PAC ID 0244143824, 268 clinicians

Practice addresses (Care Compare)

2905 5TH St
Rapid City, SD 57701-7316
Phone (605) 312-1000

525 N Foster St
Mitchell, SD 57301-2966
Phone (605) 995-5635

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
75.87
Promoting interoperability
100
Improvement activities
40
Cost
68.53

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30538IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center CurrentSince Nov 18, 2019 Accepting new patients
Sanford Medical Center Fargo Pediatrics CurrentSince Nov 1, 2018 Accepting new patients
Sanford Clinic CurrentSince Jan 1, 2004 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Nov 1, 2018 Accepting new patients
Sanford Medical Center CurrentSince Nov 18, 2019 Accepting new patients
Sanford Clinic Past Accepting new patients
Sanford Clinic Past Accepting new patients

Locations

1000 Lincoln Cir SE
Orange City, IA 51041
Phone (712) 737-2000

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

801 Broadway N
Fargo, ND 58102
Phone (701) 234-2371

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

1600 W 22nd St
Sioux Falls, SD 57105
Phone (605) 312-1000

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

Interoperability endpoints

  • Direct secure messaging: jwallace18020@direct.sanfordhealth.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1730135070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585",
            "fax_number": "605-328-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 22ND ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051521",
            "telephone_number": "605-312-1000",
            "fax_number": "605-312-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JAMES",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SD",
            "license": "3549",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "30538",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "SD",
            "license": "3549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwallace18020@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1600 W 22nd St",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571051521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.