DR. JACOB HENRY WALLACE MD
NPI 1124604061
Obstetrics & Gynecology in Saint Louis, MO
About Dr. Jacob Henry Wallace Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACOB HENRY WALLACE MD (NPI 1124604061) is an individual obstetrics & gynecology provider in Saint Louis, Missouri, licensed in Missouri (2025027770) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital - St Louis, and maintains a secondary practice location in Saint Louis.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Jacob Henry Wallace Md 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ssm Health St Mary's Hospital - St Louis
Acute Care Hospitals · Richmond Heights, MOPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 63111 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAINT LOUIS, MO 63111
SAINT LOUIS, MO 63111
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 Jacob Wallace's NPI number?
The NPI number for Jacob Wallace is 1124604061. It was assigned to this individual provider in the NPPES registry on March 22, 2021.
Where is Jacob Wallace located?
Jacob Wallace practices at 401 Holly Hills Ave, Saint Louis, MO 63111. The listed phone number is (314) 353-5190.
What is Jacob Wallace's specialty?
The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.
Is Jacob Wallace enrolled in Medicare?
Yes. Jacob 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.
What insurance does Jacob Wallace accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 3 other insurers list Jacob 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.
Is Jacob Wallace affiliated with any hospitals?
According to CMS data, Jacob Wallace is affiliated with Ssm Health St Mary's Hospital - St Louis.
When was this NPI record last updated?
The NPPES record for Jacob Wallace was last updated on July 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
