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JEFFREY MICHAEL WALLACE
NPI 1619392974
Physician Assistant in Fort Riley, KS

Active since February 24, 2014PECOS EnrolledAccepts Medicare Assignment
600 CAISSON HILL RD, FORT RILEY, KS 66442(785) 239-7000 Get Directions Write a Review

NPPES record last updated: February 24, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jeffrey Michael Wallace NPPES

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

JEFFREY MICHAEL WALLACE (NPI 1619392974) is an individual physician assistant in Fort Riley, Kansas and active in the NPI registry since February 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1619392974
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJEFFREY MICHAEL WALLACE
Location Address600 CAISSON HILL RDFort Riley, KS 66442-7037
Mailing Address600 Caisson Hill RdFort Riley, KS 66442-7037 · (785) 239-7000
Phone(785) 239-7000
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateFebruary 24, 2014
✔ NPI 1619392974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
600 CAISSON HILL RD, Fort Riley, KS 66442
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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

Jeffrey Michael 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 ID5193073211
PECOS Enrollment IDI20180807001401
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 66442 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
$81.98 typical visit price
range $53.00 – $161.67
Typical copayment $20.49 (range $13.25 – $40.41)
Most-billed visit code 99203
Established Patient
$66.40 typical visit price
range $16.88 – $132.11
Typical copayment $16.60 (range $4.22 – $33.02)
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.

DR. KELLIE MARIE PLATZ D.O.
Anesthesiology
600 CAISSON HILL RD, DEPARTMENT OF ANESTHESIOLOGY
FT RILEY, KS 66442
Riley County (785) 239-7660
MALCOLM B TORRES
Pulmonary Function Technologist
600 CAISSON HILL RD
FORT RILEY, KS 66442
Riley County (785) 239-7371
MR. MICKY D HERRON CRT
Respiratory Therapist, Certified
600 CAISSON HILL RD
FORT RILEY, KS 66442
Riley County (785) 239-7371
MR. ROY JOSEPH FOWLER OTR
Occupational Therapist
600 CAISSON HILL RD
FORT RILEY, KS 66442
Riley County (785) 240-7678
ELIZABETH ANN CINTRON
Pharmacist
600 CAISSON HILL RD
FORT RILEY, KS 66442
Riley County (785) 239-7619
ALEXANDER C VOS
Pharmacist
600 CAISSON HILL RD
FORT RILEY, KS 66442
Riley County (785) 240-7130
KARL N KELSON PA-C
Physician Assistant
600 CAISSON HILL RD
FORT RILEY, KS 66442
Riley County (785) 239-4411
SHARON DIANE SMITH LMSW
Social Worker
600 CAISSON HILL RD, IACH, FAP 2
FORT RILEY, KS 66442
Riley County (785) 239-7060

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 Jeffrey Wallace's NPI number?

The NPI number for Jeffrey Wallace is 1619392974. It was assigned to this individual provider in the NPPES registry on February 24, 2014.

Where is Jeffrey Wallace located?

Jeffrey Wallace practices at 600 Caisson Hill Rd, Fort Riley, KS 66442. The listed phone number is (785) 239-7000.

What is Jeffrey Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jeffrey Wallace enrolled in Medicare?

Yes. Jeffrey 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.

When was this NPI record last updated?

The NPPES record for Jeffrey Wallace was last updated on February 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.