Jodi Beth Wallis, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

271804 Issued in NY

Practice address

725 Irving Ave
Ste 600
Syracuse, NY 13210-1603

Phone

(315) 464-5162

Fax

(315) 464-4613

NPI assigned

Feb 1, 2009

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

Other identifiers 1

Other names 1

• Dr. Jodi Beth Kaplan Former name

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwallis2367052@direct.trinity-health.org

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.

• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Medicare reassignment NPD
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  Medicare reassignment NPD
• University OB/GYN Associates

  • Gynecology Physician
  • Syracuse, NY
  • NPI 1235170150

  Obstetrics & Gynecology

  Medicare reassignment NPD
• St Joseph'S Hospital Health Center

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1699832436

  Obstetrics & Gynecology

  NPD

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

{
    "created_epoch": "1233446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384387200000",
    "number": "1811135684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE",
            "address_2": "STE 600",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101603",
            "telephone_number": "315-464-5162",
            "fax_number": "315-464-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE",
            "address_2": "STE 600",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101603",
            "telephone_number": "315-464-5162",
            "fax_number": "315-464-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "JODI",
        "middle_name": "BETH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-01",
        "last_updated": "2013-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "271804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03657994",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODI",
            "last_name": "KAPLAN",
            "middle_name": "BETH",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erin Wallace
• Kyrsten Wallace, MD
• Jason M Wallen, MD
• Kim Gabrielle Wallenstein, M.D., PH.D.
• Laura Waller, LMT
• Christopher Wallon
• Hiba Tariq Wally, MBBS
• Christine Walpole
• Howard S Walsdorf, DC
• Marguerite S Walser, NP

• Obstetrics & Gynecology Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.