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MR. JASON DAVID WALLACE
NPI 1235755638
Nurse Practitioner - Psychiatric/Mental Health in Jonesboro, AR

Active since June 22, 2020PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
2214 CHESAPEAKE CV, JONESBORO, AR 72404(615) 618-6200 Get Directions Write a Review

NPPES record last updated: May 14, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 14, 2025, Jun 22, 2020 (2 updates tracked since 2020).

About Mr. Jason David Wallace NPPES

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

MR. JASON DAVID WALLACE (NPI 1235755638) is an individual psychiatric/mental health provider in Jonesboro, Arkansas, licensed in Arkansas (125806) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1235755638
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMR. JASON DAVID WALLACE
Location Address2214 CHESAPEAKE CVJonesboro, AR 72404-7104
Mailing Address2616 Gallaway CvJonesboro, AR 72404-7827 · (615) 618-6200
Phone(615) 618-6200
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateJune 22, 2020
Last NPPES UpdateMay 14, 20252 updates tracked since enumeration
NPPES CertifiedMay 14, 2025
✔ NPI 1235755638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in AR · 125806
2214 CHESAPEAKE CV, Jonesboro, AR 72404
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Health Advantage, Octave.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

Mr. Jason David Wallace 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.

PECOS PAC ID2062836596
PECOS Enrollment IDI20200716003457
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.

Medicare Billing Reassignments

7

Medicare enrollment records show Jason Wallace reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Renew Mental Health And Wellness LLC
4.6 mi
Psychiatric/Mental Health
1150 E MATTHEWS AVE STE 101A
Jonesboro, AR 72401
  • Reassigned Medicare billing, Arkansas enrollment
  • 37 clinicians in this Medicare group
NPI 1447817572 (870) 243-0424
St. Bernards Hospital, Inc
6.2 mi
Obstetrics
4334 E HIGHLAND DR STE B
Jonesboro, AR 72401
  • Reassigned Medicare billing, Arkansas enrollment
  • 79 clinicians in this Medicare group
NPI 1518327287 (870) 207-0421
Delta Behavioral Health, LLC
34 mi
Mental Health (Including Community Mental Health Center)
603 W FLEEMAN STE 4
Manila, AR 72442
  • Reassigned Medicare billing, Arkansas enrollment
  • 9 clinicians in this Medicare group
NPI 1720637085 (870) 570-0358
Ipc Pac Healthcare Services Of Missouri Inc
99 mi
Hospitalist
760 PLANTATION BLVD STE 210
Sikeston, MO 63801
  • Reassigned Medicare billing, Arkansas enrollment
  • 23 clinicians in this Medicare group
NPI 1326497587 (573) 471-0800
Supportive Psych Care Of Arkansas PA
215 mi
Psychiatry
811 W ELGIN ST
Siloam Springs, AR 72761
  • Reassigned Medicare billing, Arkansas enrollment
  • 78 clinicians in this Medicare group
NPI 1437887437 (718) 298-2753
Cs Pacs 3 Southwest, LLC
484 mi
Hospitalist
5800 W BAKER RD
Baytown, TX 77520
  • Reassigned Medicare billing, Arkansas enrollment
  • 17 clinicians in this Medicare group
NPI 1275398430 (281) 425-1200
Nv Pacs 2 LLC
1,374 mi
Hospitalist
10550 PARK RUN DR
Las Vegas, NV 89144
  • Reassigned Medicare billing, Arkansas enrollment
  • 22 clinicians in this Medicare group
NPI 1427534809 (865) 693-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
1,448 services232 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
281 services59 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
174 services173 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
156 services67 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
23 services23 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
21 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72404 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
$79.72 typical visit price
range $51.36 – $157.74
Typical copayment $19.93 (range $12.84 – $39.43)
Most-billed visit code 99203
Established Patient
$91.63 typical visit price
range $16.16 – $128.77
Typical copayment $22.90 (range $4.04 – $32.19)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality90
Improvement Activities40
Cost100

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 Jason Wallace's NPI number?

The NPI number for Jason Wallace is 1235755638. It was assigned to this individual provider in the NPPES registry on June 22, 2020.

Where is Jason Wallace located?

Jason Wallace practices at 2214 Chesapeake Cv, Jonesboro, AR 72404. The listed phone number is (615) 618-6200.

What is Jason Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jason Wallace enrolled in Medicare?

Yes. Jason 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 organizations bill Medicare for Jason Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jason Wallace reassigns Medicare benefits to 7 organizations: Renew Mental Health And Wellness LLC (Jonesboro, AR), St. Bernards Hospital, Inc (Jonesboro, AR), Delta Behavioral Health, LLC (Manila, AR), Ipc Pac Healthcare Services Of Missouri Inc (Sikeston, MO), Supportive Psych Care Of Arkansas PA (Siloam Springs, AR) and 2 more organizations, listed in the Medicare section above. Each 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 Jason Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jason Wallace accept?

Health plans from Health Advantage and Octave list Jason 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 Jason Wallace was last updated on May 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.