JENNIFER LYN WALLACE MD
NPI 1730154154
Family Medicine in Portland, OR
About Jennifer Lyn Wallace Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JENNIFER LYN WALLACE MD (NPI 1730154154) is an individual family medicine provider in Portland, Oregon, licensed in Oregon (MD24427) and active in the NPI registry since February 2006. She has opted out of Medicare through May 19, 2027 and remains eligible to order and refer and holds a CLIA Waiver certificate valid through August 25, 2027.
NPPES Registry Identity
Specialties & Licenses
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Jennifer Lyn Wallace Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 19, 2017 through May 19, 2027.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 38D1104174
Jennifer Wallace MD · Portland, ORPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PORTLAND, OR 97202
PORTLAND, OR 97202
PORTLAND, OR 97202
PORTLAND, OR 97202
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 Jennifer Wallace's NPI number?
The NPI number for Jennifer Wallace is 1730154154. It was assigned to this individual provider in the NPPES registry on February 20, 2006.
Where is Jennifer Wallace located?
Jennifer Wallace practices at 1235 SE Division St Suite 208, Portland, OR 97202. The listed phone number is (888) 480-1115.
What is Jennifer Wallace's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Jennifer Wallace enrolled in Medicare?
No. Jennifer Wallace has opted out of Medicare through May 19, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
Does Jennifer Wallace hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 38D1104174) is associated with this NPI, valid through August 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Jennifer Wallace accept?
Health plans from Providence Health Plan list Jennifer 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 Jennifer Wallace was last updated on March 18, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.
