Jill Amy Wallace-Ross, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS10880 Issued in FL

Practice address

3200 S. University Drive
Sanford L. Ziff BLDG.
Ft. Lauderdale, FL 33328-2018

Phone

(954) 262-4100

Fax

(954) 262-2271

NPI assigned

Feb 11, 2009

Last updated

Feb 15, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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 FL

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

Family Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nova Southeastern University IncGroup PAC ID 4486568896, 97 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

72.47 of 100Reported as group

Quality

62.45

Improvement activities

40

Cost

73.28

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nova Southeastern University, Inc

  • Optometrist
  • Fort Lauderdale, FL
  • NPI 1700924511
  Medicare reassignment Care Compare group NPD
• Nsu-Covenant Village Laboratory

  • Clinical Medical Laboratory
  • Plantation, FL
  • NPI 1477958247
  Authorized official Same address or phone
• Nova Southeastern University Inc.

  • Clinical Medical Laboratory
  • Fort Lauderdale, FL
  • NPI 1770533390
  NPD
• Nova Southeastern University, Inc

  • Family Medicine Physician
  • North Miami Beach, FL
  • NPI 1881732634
  NPD
• Nova Southeastern University, Inc

  • Family Medicine Physician
  • Davie, FL
  • NPI 1447345517
  NPD (past)
• Nova Southeastern University, Inc

  • Optometrist
  • Davie, FL
  • NPI 1588802169
  NPD (past)

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1770722043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S. UNIVERSITY DRIVE",
            "address_2": "ASSEMBLY BLDG. # 2 ROOM 202",
            "city": "FT. LAUDERDALE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4343",
            "fax_number": "954-262-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S. UNIVERSITY DRIVE",
            "address_2": "SANFORD L. ZIFF BLDG.",
            "city": "FT. LAUDERDALE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4100",
            "fax_number": "954-262-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE-ROSS",
        "first_name": "JILL",
        "middle_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS10880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia B Walker, MSW, LCSW
• Savannah Walker
• Scott F Walker
• Tiffannie Walker, M.D.
• George L Wallace-Barnhill, PHD LMHC
• Dana V Wallace, MD
• Gabrielle Wallace, CRNA
• Grace Christianne Manuela Wallace, WHNP
• Jenece Wallace
• Karina M Wallace, BCBA,

• Family Medicine Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.