1. Home
  2. Directory
  3. Kentucky
  4. Lexington
  5. Surgery
  6. NPI Profile

JERALD PAYDEN WALLACE M.D.
NPI 1730591017
Surgery in Lexington, KY

Active since May 21, 2014PECOS EnrolledAccepts Medicare Assignment
79.32/100
CMS Quality Rating
800 ROSE ST, C246, LEXINGTON, KY 40536(859) 323-6162 Get Directions Write a Review

NPPES record last updated: July 7, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jerald Payden Wallace M.d. NPPES

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

JERALD PAYDEN WALLACE M.D. (NPI 1730591017) is an individual surgery provider in Lexington, Kentucky, licensed in Kentucky (49437) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (2014).

NPPES Registry Identity

NPI1730591017
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJERALD PAYDEN WALLACECredential: M.D.
Location Address800 ROSE ST, C246Lexington, KY 40536-0293
Mailing Address800 Rose St, C246Lexington, KY 40536-0293 · (859) 323-6162
Phone(859) 323-6162
Sole ProprietorNo
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2014
Enumeration DateMay 21, 2014
Last NPPES UpdateJuly 7, 2016
✔ NPI 1730591017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in KY · 49437
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
800 ROSE ST, Lexington, KY 40536
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama and more.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

Jerald Payden Wallace M.d. 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 ID840587465
PECOS Enrollment IDI20200413004166
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.

Areas of Expertise CMS Part B claims 9

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.

Removal of muscle and/or tissue, 20.0 sq cm or less 11043
This procedure involves the surgical removal of a specified area (20.0 sq cm or less) of muscle and/or tissue. It's typically done to treat conditions like tumors, infections, or injuries. Local or general anesthesia ensures comfort. Recovery time varies.
85 services18 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
71 services34 patients
Removal of skin and tissue, 20.0 sq cm or less 11042
This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
43 services21 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
42 services29 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
30 services27 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
26 services26 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40536 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
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.

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.

79.32/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality67.32
Promoting Interoperability92
Improvement Activities40
Cost70.42

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. JEREMY WAYNE THACKER M.D.
Radiology (Diagnostic Radiology)
800 ROSE ST, HX-302 UKMC
LEXINGTON, KY 40536
Fayette County (859) 257-4457
DR. KIRK PHILLIP HEITMAN M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
800 ROSE ST, MS117
LEXINGTON, KY 40536
Fayette County (859) 257-1446
HARISH RAM MD
Anesthesiology
800 ROSE ST
LEXINGTON, KY 40536
Fayette County (859) 323-5956
MS. YVONNE P RICE APRN NP-C
Nurse Practitioner (Family)
800 ROSE ST
LEXINGTON, KY 40536
Fayette County (859) 218-1779
VANESSA D. SMITH MD
Pathology (Anatomic Pathology)
800 ROSE ST
LEXINGTON, KY 40536
Fayette County (859) 323-6183
JASMINE HOWARD APRN
Nurse Practitioner (Acute Care)
800 ROSE ST, MN604
LEXINGTON, KY 40536
Fayette County (859) 323-6047
MITCHELL ALEXANDER MIGUEL M.D.
Hospitalist
800 ROSE ST
LEXINGTON, KY 40536
Fayette County (859) 323-6047
LEAH RAY YEAGER APRN
Nurse Practitioner (Family)
800 ROSE ST, CC417
LEXINGTON, KY 40536
Fayette County (859) 257-1223

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 Jerald Wallace's NPI number?

The NPI number for Jerald Wallace is 1730591017. It was assigned to this individual provider in the NPPES registry on May 21, 2014.

Where is Jerald Wallace located?

Jerald Wallace practices at 800 Rose St C246, Lexington, KY 40536. The listed phone number is (859) 323-6162.

What is Jerald Wallace's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Jerald Wallace enrolled in Medicare?

Yes. Jerald 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 Jerald Wallace accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer list Jerald 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 Jerald Wallace was last updated on July 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.