DR. JEFFREY H WALLEN DDS
NPI 1497729396
Oral & Maxillofacial Surgery in Myrtle Beach, SC
NPI Status: Active since February 15, 2006
Contact Information
1200 48TH AVE N
SUITE 101
MYRTLE BEACH, SC
ZIP 29577
Phone: (843) 449-4993
Fax: (843) 497-0647
- Individual
- Male
- Oral & Maxillofacial Surgery
- PECOS Enrolled
- Opted-Out Medicare
About JEFFREY WALLEN
This page provides the complete NPI Profile along with additional information for Jeffrey Wallen, a provider established in Myrtle Beach, South Carolina with a medical specialization in Oral & Maxillofacial Surgery. The healthcare provider is registered in the NPI registry with number 1497729396 assigned on February 2006. The practitioner's primary taxonomy code is 204E00000X with license number 2959 (SC). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1497729396
- Provider Name
- DR. JEFFREY H WALLEN DDS
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1200 48TH AVE N SUITE 101 MYRTLE BEACH, SC 29577
- Location Phone
- (843) 449-4993
- Location Fax
- (843) 497-0647
- Mailing Address
- 1200 48TH AVE N SUITE 101 MYRTLE BEACH, SC 29577
- Mailing Phone
- (843) 449-4993
- Mailing Fax
- (843) 497-0647
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 02-15-2006
- Last Update Date
- 07-08-2007
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jeffrey Wallen opted out of Medicare effective on 10-01-2020 until 10-01-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Oral & Maxillofacial Surgery
- Taxonomy Code
- 204E00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 2959
- License State
- SC
- Taxonomy Description
- Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| U56498 | MEDICARE UPIN (02) | ||
| 8998844 | MEDICAID (05) | NC | |
| ZA9905 | MEDICAID (05) | SC |
Medicare Participation & PECOS Enrollment Status
Jeffrey Wallen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 10-01-2020
Opt-Out End Date: 10-01-2026
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1497729396, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 74 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497729396, enumerated as an "individual" on February 15, 2006.
The provider is located at 1200 48TH AVE N SUITE 101 MYRTLE BEACH, SC 29577 and the phone number is (843) 449-4993.
Oral & Maxillofacial Surgery with taxonomy code 204E00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
