JORGE WALLACE PLPC
NPI 1164852422
Counselor - Professional in Saint Louis, MO
About Jorge Wallace Plpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JORGE WALLACE PLPC (NPI 1164852422) is an individual professional provider in Saint Louis, Missouri, licensed in Missouri (2011039643) and active in the NPI registry since November 2013. He is enrolled in Medicare PECOS and is a graduate of Other (2010).
NPPES Registry Identity
Specialties & Licenses
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
Jorge Wallace Plpc 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 Jorge Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lynchburg, VA 24504
- Reassigned Medicare billing, District of Columbia enrollment
- 143 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 Jorge Wallace's NPI number?
The NPI number for Jorge Wallace is 1164852422. It was assigned to this individual provider in the NPPES registry on November 22, 2013.
Where is Jorge Wallace located?
Jorge Wallace practices at 6532 Bartmer Ave 2E, Saint Louis, MO 63130. The listed phone number is (314) 299-5284.
What is Jorge Wallace's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Jorge Wallace enrolled in Medicare?
Yes. Jorge 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 organization bills Medicare for Jorge Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jorge Wallace reassigns Medicare benefits to Thrive Counseling LLC (Lynchburg, VA). 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 Jorge Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jorge Wallace was last updated on May 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Jorge Wallace, PLPC · NPI 1164852422
Professional provider in Saint Louis, Missouri. Individual provider, active in the CMS NPPES registry since November 22, 2013.
## Identity
- **NPI:** 1164852422 (Entity type: Individual)
- **Enumerated:** November 22, 2013
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 2011039643 (Missouri)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6532 BARTMER AVE, 2E, Saint Louis, MO 63130-2630
- **Phone:** (314) 299-5284
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Thrive Counseling LLC (NPI 1215181300, Lynchburg, VA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2010
## Record status
- **NPPES last updated:** May 26, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1164852422) · Data from the CMS NPPES public registry.