JACOB RICHARD WALLACE APRN
NPI 1275163263
Nurse Anesthetist, Certified Registered in Rochester, MN

Active since January 19, 2020Accepts Medicare Assignment
200 1ST ST SW, ROCHESTER, MN 55905(507) 284-2511 Get Directions Write a Review

NPPES record last updated: October 5, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 5, 2020, Feb 11, 2020, Jan 19, 2020 (3 updates tracked since 2020).

About Jacob Richard Wallace Aprn NPPES

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

JACOB RICHARD WALLACE APRN (NPI 1275163263) is an individual nurse anesthetist, certified registered in Rochester, Minnesota, licensed in Minnesota (2447) and active in the NPI registry since January 2020. He is affiliated with Mayo Clinic Hospital Rochester and is a graduate of Other (2020).

NPPES Registry Identity

NPI1275163263
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameJACOB RICHARD WALLACECredential: APRN
Location Address200 1ST ST SWRochester, MN 55905-0001
Mailing Address200 1st St SwRochester, MN 55905-0001 · (507) 284-2511
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJanuary 19, 2020
Last NPPES UpdateOctober 5, 20203 updates tracked since enumeration
NPPES CertifiedOctober 5, 2020
NPI 1275163263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License Licensed in MN · 2447
Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

200 1ST ST SW, Rochester, MN 55905

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

Jacob Richard Wallace Aprn 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 ID3577990050
PECOS Enrollment IDI20200221001880

Areas of Expertise CMS Part B claims

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.

Anesthesia for other procedure on neck area (1 year or older) 00320
Anesthesia for a procedure on the neck area is a medical service provided to ensure you remain comfortable and pain-free during the operation. It involves administering medication to numb the neck region or to induce sleep. The method chosen depends on the specific procedure and your overall health.
14 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mayo Clinic Hospital Rochester

Acute Care Hospitals · Rochester, MN
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number240010
Location1216 Second Street SouthwestRochester, MN 55902 · Olmsted County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55905 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
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
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.

Radiology (Diagnostic Radiology)
200 1ST ST SW
ROCHESTER, MN 55905
Dermatology
200 1ST ST SW
ROCHESTER, MN 55905
Physician Assistant
200 1ST ST SW
ROCHESTER, MN 55905
Internal Medicine (Medical Oncology)
200 1ST ST SW
ROCHESTER, MN 55905
Pediatrics
200 1ST ST SW
ROCHESTER, MN 55905
Oral & Maxillofacial Surgery
200 1ST ST SW
ROCHESTER, MN 55905
Radiology (Diagnostic Radiology)
200 1ST ST SW
ROCHESTER, MN 55905
Internal Medicine (Gastroenterology)
200 1ST ST SW
ROCHESTER, MN 55905

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 1275163263. It was assigned to this individual provider in the NPPES registry on January 19, 2020.

Where is Jacob Wallace located?

Jacob Wallace practices at 200 1st St SW, Rochester, MN 55905. The listed phone number is (507) 284-2511.

What is Jacob Wallace's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

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 Medica 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 Mayo Clinic Hospital Rochester.

When was this NPI record last updated?

The NPPES record for Jacob Wallace was last updated on October 5, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.