Active NPI
Jason M Wallen, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Syracuse, NY
National Provider Identifier
1730285370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 282319
- Practice address
- 750 East Adams St
Syracuse, NY 13210 - Phone
- (315) 464-1800
- Fax
- (315) 464-6238
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A81230 | CA | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 282319 | NY | Primary |
Addresses
Primary practice location
750 East Adams St
Syracuse, NY 13210
Mailing address
251 Salina Meadows Pkwy Ste 100
Syracuse, NY 13212-4516
Phone (315) 464-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Thoracic Surgery
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
725 Irving Ave
Suite 401
Syracuse, NY 13210-1684
Phone (315) 464-2878
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.86 of 100
- Quality
- 83.98
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.23
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 21 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81230 | CA | MD | Marriage & Family Therapist |
| A81230 | CA | MD | Surgery Physician |
| 282319 | NY | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suny Health Science Center at Syracuse | Past | Accepting new patients |
Interoperability endpoints
- jwallen52334@direct.upstate.edu
Organizations & group practices 2
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.
-
- Surgery Physician
- Syracuse, NY
- NPI 1376590117
-
- General Acute Care Hospital
- Syracuse, NY
- NPI 1578554630
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Syracuse, NY
- NPI 1033107743
-
- General Acute Care Hospital
- Syracuse, NY
- NPI 1578554630
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1730285370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 SALINA MEADOWS PKWY STE 100",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132124516",
"telephone_number": "315-464-2000",
"fax_number": "315-464-2010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 EAST ADAMS ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "13210",
"telephone_number": "315-464-1800",
"fax_number": "315-464-6238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLEN",
"first_name": "JASON",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A81230",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "NY",
"license": "282319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.