JESSE L WALLACE AG-ACNP
NPI 1013697267
Nurse Practitioner - Acute Care in Charlottesville, VA
About Jesse L Wallace Ag-acnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSE L WALLACE AG-ACNP (NPI 1013697267) is an individual acute care provider in Charlottesville, Virginia, licensed in Virginia (0024187479) and active in the NPI registry since July 2023. He is enrolled in Medicare PECOS, is affiliated with University Of Virginia Medical Center, and maintains a secondary practice location in Charlottesville.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jesse L Wallace Ag-acnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Jesse Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Charlottesville, VA 22911
- Reassigned Medicare billing, Virginia enrollment
- 307 clinicians in this Medicare group
Charlottesville, VA 22911
- Reassigned Medicare billing, Virginia enrollment
- 2,820 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
University Of Virginia Medical Center
Acute Care Hospitals · Charlottesville, VAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 22911 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHARLOTTESVILLE, VA 22911
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jesse Wallace's NPI number?
The NPI number for Jesse Wallace is 1013697267. It was assigned to this individual provider in the NPPES registry on July 24, 2023.
Where is Jesse Wallace located?
Jesse Wallace practices at 500 Martha Jefferson Dr Ste 505, Charlottesville, VA 22911. The listed phone number is (434) 654-5260.
What is Jesse Wallace's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Jesse Wallace enrolled in Medicare?
Yes. Jesse Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jesse Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jesse Wallace reassigns Medicare benefits to 2 organizations: Martha Jefferson Medical Group LLC (Charlottesville, VA) and University Of Virginia Physicians Group (Charlottesville, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jesse Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Jesse Wallace affiliated with any hospitals?
According to CMS data, Jesse Wallace is affiliated with University Of Virginia Medical Center.
When was this NPI record last updated?
The NPPES record for Jesse Wallace was last updated on May 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jesse L Wallace, AG-ACNP · NPI 1013697267
Acute Care physician in Charlottesville, Virginia. Individual provider, active in the CMS NPPES registry since July 24, 2023.
## Identity
- **NPI:** 1013697267 (Entity type: Individual)
- **Enumerated:** July 24, 2023
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** 0024187479 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 500 MARTHA JEFFERSON DR STE 505, Charlottesville, VA 22911-4668
- **Phone:** (434) 654-5260 · **Fax:** (434) 654-5261
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Martha Jefferson Medical Group LLC (NPI 1275720559, Charlottesville, VA); University Of Virginia Physicians Group (NPI 1033138250, Charlottesville, VA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** May 11, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1013697267) · Data from the CMS NPPES public registry.