1. Home
  2. Directory
  3. New York
  4. Manhasset
  5. Nurse Practitioner
  6. NPI Profile

JEAN A. WALLACE NP
NPI 1144480088
Nurse Practitioner - Neonatal in Manhasset, NY

Active since June 13, 2008PECOS Enrolled
300 COMMUNITY DR, MANHASSET, NY 11030(516) 562-4665 Get Directions Write a Review

NPPES record last updated: June 13, 2008. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Jean A. Wallace Np NPPES

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

JEAN A. WALLACE NP (NPI 1144480088) is an individual neonatal provider in Manhasset, New York, licensed in New York (F350149) and active in the NPI registry since June 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1144480088
Entity TypeIndividualFemale
Primary Taxonomy363LN0000X
Provider Legal NameJEAN A. WALLACECredential: NP
Location Address300 COMMUNITY DRManhasset, NY 11030-3816
Mailing Address130 Elmwood DrDix Hills, NY 11746-5658 · (631) 549-1357
Phone(516) 562-4665
Sole ProprietorYes
Enumeration DateJune 13, 2008
✔ NPI 1144480088 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · NeonatalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LN0000X
License✔ Licensed in NY · F350149
300 COMMUNITY DR, Manhasset, NY 11030
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jean A. Wallace Np 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 11030 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
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 20

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

SAMIT SHAH M.D.
Internal Medicine (Advanced Heart Failure and Transplant Cardiology)
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-1427
DR. SAMANTHA LING PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-8761
DR. DIANA RACHAEL NORDQUIST MD
Anesthesiology
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-8630
DR. STEPHEN JOHN CIPOT IV D.O.
Emergency Medicine
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 684-7598
MR. JOSE LUIS CRUZ PA-C
Physician Assistant
300 COMMUNITY DR, NORTH SHORE UNIVERSITY HOSPITAL
MANHASSET, NY 11030
Nassau County (516) 562-3683
SARAH BETH KORNHABER C.R.N.A.
Nurse Anesthetist, Certified Registered
300 COMMUNITY DR, DEPT OF ANESTHESIA
MANHASSET, NY 11030
Nassau County (516) 562-4887
YUSON CHONG NP
Nurse Practitioner (Acute Care)
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-2252
THERESA MARY MOUZAKITIS PA
Physician Assistant
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 662-5100

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 Jean Wallace's NPI number?

The NPI number for Jean Wallace is 1144480088. It was assigned to this individual provider in the NPPES registry on June 13, 2008.

Where is Jean Wallace located?

Jean Wallace practices at 300 Community Dr, Manhasset, NY 11030. The listed phone number is (516) 562-4665.

What is Jean Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, with taxonomy code 363LN0000X.

Is Jean Wallace enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jean Wallace was last updated on June 13, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.