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DR. JAMILA SHANI WALLACE OD
NPI 1033798079
Optometrist in South Pasadena, CA

Active since April 06, 2021PECOS Enrolled
1103 FAIR OAKS AVE, SOUTH PASADENA, CA 91030(626) 441-0770 Get Directions Write a Review

NPPES record last updated: April 6, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jamila Shani Wallace Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAMILA SHANI WALLACE OD (NPI 1033798079) is an individual optometrist in South Pasadena, California, licensed in California (34793) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033798079
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. JAMILA SHANI WALLACECredential: OD
Location Address1103 FAIR OAKS AVESouth Pasadena, CA 91030-3311
Mailing Address1103 Fair Oaks AveSouth Pasadena, CA 91030-3311
Phone(626) 441-0770
Sole ProprietorNo
Enumeration DateApril 6, 2021
NPPES CertifiedApril 6, 2021
✔ NPI 1033798079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in CA · 34793
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
1103 FAIR OAKS AVE, South Pasadena, CA 91030
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jamila Shani Wallace Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91030 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUSTIN HU, O.D., INCORPORATED
Optometrist
1103 FAIR OAKS AVE
SOUTH PASADENA, CA 91030
Los Angeles County (626) 441-0770
JUSTIN HU, O.D., INCORPORATED
Optometrist
1103 FAIR OAKS AVE
SOUTH PASADENA, CA 91030
Los Angeles County (626) 441-0770
OFFICE OF ALAN LEVENTHAL P.C.
Eyewear Supplier
1103 FAIR OAKS AVE
SOUTH PASADENA, CA 91030
Los Angeles County (626) 441-0770
VISUAL SPECTRUM
Technician/Technologist (Optician)
1103 FAIR OAKS AVE
SOUTH PASADENA, CA 91030
Los Angeles County (626) 441-0770
JUSTIN HU O.D.
Optometrist
1103 FAIR OAKS AVE
SOUTH PASADENA, CA 91030
Los Angeles County (626) 441-0770

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 Jamila Wallace's NPI number?

The NPI number for Jamila Wallace is 1033798079. It was assigned to this individual provider in the NPPES registry on April 6, 2021.

Where is Jamila Wallace located?

Jamila Wallace practices at 1103 Fair Oaks Ave, South Pasadena, CA 91030. The listed phone number is (626) 441-0770.

What is Jamila Wallace's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Jamila Wallace enrolled in Medicare?

Yes. Jamila Wallace is registered in the Medicare PECOS enrollment system.

What insurance does Jamila Wallace accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 1 other insurer list Jamila Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jamila Wallace was last updated on April 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.