Jason R Wallace, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DR.0050788 Issued in CO

Practice address

95 S Pagosa Blvd
Pagosa Springs, CO 81147-8329

Phone

(970) 731-3700

NPI assigned

Apr 1, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO, AK2 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

Specialty

Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Providence Health and Services- WashingtonGroup PAC ID 1557408176, 219 clinicians

Upper San Juan Health Service DistrictGroup PAC ID 2769571892, shared by 3 NPIs, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence at Home With Compassus HH Anchorage Home health agency, Anchorage, AK, CCN 027001
• St. Agatha Home Healthcare, LLC Home health agency, Anchorage, AK, CCN 027306
• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001
• Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013
• Pagosa Springs Medical Center Hospital, Pagosa Springs, CO, CCN 061328

Merit-based Incentive Payment System (MIPS)

Final score

95.74 of 100Reported as group

Quality

92.26

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jasonwallace@psmedicalcenter.cernerdirect.com
• Direct secure messaging: jwallace3813800@ak.providencedirect.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.

• Providence Health & Services- Washington

  • Critical Care Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1093956278

  AK

  Medicare reassignment Care Compare group NPD
• Upper San Juan Health Service District

  • Critical Access Hospital
  • Pagosa Springs, CO
  • NPI 1659523058

  CO

  Medicare reassignment NPD
• Upper San Juan Health Service District

  • Critical Access Hospital
  • Pagosa Springs, CO
  • NPI 1245401561
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1083611644

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1588204010

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1679113104

  Hospital

  Care Compare affiliation
• Upper San Juan Health Service District

  • Critical Access Hospital
  • Pagosa Springs, CO
  • NPI 1245401561

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Aztec, NM
  • NPI 1770123382

  Hospital

  Care Compare affiliation
• CP Ak HH, LLC

  • Home Health Agency
  • Anchorage, AK
  • NPI 1134941156
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119

  Hospital

  Care Compare affiliation
• St Agatha Home Healthcare LLC

  • Home Health Agency
  • Anchorage, AK
  • NPI 1669211926
  Care Compare affiliation

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1992020937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 S PAGOSA BLVD",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811478329",
            "telephone_number": "970-731-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 S PAGOSA BLVD",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811478329",
            "telephone_number": "970-731-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-01",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0050788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JasonWallace@psmedicalcenter.cernerdirect.com",
            "affiliation": "N",
            "address_1": "95 S Pagosa Blvd",
            "city": "Pagosa Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "811478329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Pagosa Springs, CO
• Providers in Pagosa Springs, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.