Active NPI
James M Wallace, M.D.
- Internal Medicine Physician
- Saint Croix Falls, WI
National Provider Identifier
1902908718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 37316
- Practice address
- 235 E State St
Saint Croix Falls, WI 54024-4117 - Phone
- (715) 483-3221
- Fax
- (715) 483-0507
- NPI assigned
- Sep 2, 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 37316 | WI | |
| Internal Medicine Physician | 207R00000X | 37316 | WI | Primary |
Addresses
Primary practice location
235 E State St
Saint Croix Falls, WI 54024-4117
Mailing address
235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP27845 | Other | HEALTHPARTNERS | |
| 64Q42WA | Other | MN | BLUE CROSS MN PRO FEE |
| 948017000 | Medicaid | MN | |
| 110168453 | Other | RAILROAD | |
| NA9031017009 | Other | PREFERREDONE | |
| 32379700 | Medicaid | WI | |
| 0413704 | Other | MEDICA | |
| 27G52WA | Other | MN | BLUE CROSS MN FACILITY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jwallace156462@excellian.direct.allina.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Minnesota Medical School, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12375 Lindstrom LN
Lindstrom, MN 55045-9551
Phone (651) 400-2240
1504 190TH Ave
Balsam Lake, WI 54810-7102
Phone (715) 825-3278
235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221
235 State St
St Croix Falls, WI 54024-4117
Hospital & facility affiliations
- Good Samaritan Society - Home Care
- Accentcare Fairview Home Health - West, LLC
- Adoray Home Health and Hospice
- St Croix Hospice Eau Claire
- St Croix Regional Medical Center
- Abbott Northwestern Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Croix Regional Medical Center | Current | Accepting new patients | |
| St. Croix Regional Medical Center | Current | Accepting new patients |
Locations
216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426
204 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-3221
235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221
Interoperability endpoints
- jwallace156462@excellian.direct.allina.com
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.
-
- Rural Health Clinic/Center
- Balsam Lake, WI
- NPI 1013423219
Hospital & facility affiliations 28
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Community Based Hospice Care Agency
- Eau Claire, WI
- NPI 1841601952
-
- Critical Access Hospital
- Saint Croix Falls, WI
- NPI 1043240922
-
- Home Health Agency
- Baldwin, WI
- NPI 1689679094
-
- Home Health Agency
- Saint Croix Falls, WI
- NPI 1568627156
-
- Home Health Agency
- Saint Paul, MN
- NPI 1477169233
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612224000000",
"number": "1902908718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 E STATE ST",
"city": "SAINT CROIX FALLS",
"state": "WI",
"postal_code": "540244117",
"telephone_number": "715-483-3221",
"fax_number": "715-483-0507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 E STATE ST",
"city": "SAINT CROIX FALLS",
"state": "WI",
"postal_code": "540244117",
"telephone_number": "715-483-3221",
"fax_number": "715-483-0507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "JAMES",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-02",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "37316",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "37316",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP27845",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS MN PRO FEE",
"identifier": "64Q42WA",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "948017000",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "110168453",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERREDONE",
"identifier": "NA9031017009",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32379700",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0413704",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS MN FACILITY",
"identifier": "27G52WA",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jwallace156462@excellian.direct.allina.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/PDF/TXT",
"address_1": "235 E State St",
"city": "Saint Croix Falls",
"state": "WI",
"country_code": "US",
"postal_code": "540244117",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Saint Croix Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.