JAKE WALLIN
NPI 1124604772
Counselor - Mental Health in Orlando, FL
About Jake Wallin NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JAKE WALLIN (NPI 1124604772) is an individual mental health provider in Orlando, Florida and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Kalamazoo, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
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
Jake Wallin 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 Reassignment
Medicare enrollment records show Jake Wallin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Kalamazoo, MI 49009
- Reassigned Medicare billing, Michigan enrollment
- 11 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.
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 Jake Wallin's NPI number?
The NPI number for Jake Wallin is 1124604772. It was assigned to this individual provider in the NPPES registry on March 23, 2021.
Where is Jake Wallin located?
Jake Wallin practices at 3612 Westland Dr, Orlando, FL 32818. The listed phone number is (407) 434-9792.
What is Jake Wallin's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Jake Wallin enrolled in Medicare?
Yes. Jake Wallin 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 organization bills Medicare for Jake Wallin's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jake Wallin reassigns Medicare benefits to Diane M Kanous (Kalamazoo, MI). The 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 Jake Wallin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jake Wallin accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 5 other insurers list Jake Wallin 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 Jake Wallin was last updated on March 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Jake Wallin · NPI 1124604772
Mental Health provider in Orlando, Florida. Individual provider, active in the CMS NPPES registry since March 23, 2021.
## Identity
- **NPI:** 1124604772 (Entity type: Individual)
- **Enumerated:** March 23, 2021
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** No
## Practice location
- **Address:** 3612 WESTLAND DR, Orlando, FL 32818-2807
- **Phone:** (407) 434-9792
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Diane M Kanous (NPI 1588837736, Kalamazoo, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** March 19, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1124604772) · Data from the CMS NPPES public registry.