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JESSICA DANIELLE WALLACE MD
NPI 1740978824
Student in an Organized Health Care Education/Training Program in Denver, CO

Active since April 27, 2023PECOS Enrolled
3055 ROSLYN ST UNIT 100, DENVER, CO 80238(720) 553-2696 Get Directions Write a Review

NPPES record last updated: April 27, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jessica Danielle Wallace Md NPPES

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

JESSICA DANIELLE WALLACE MD (NPI 1740978824) is an individual student in an organized health care education/training program in Denver, Colorado, licensed in Colorado (TL.0009795) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740978824
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJESSICA DANIELLE WALLACECredential: MD
Location Address3055 ROSLYN ST UNIT 100Denver, CO 80238-3324
Mailing Address3055 Roslyn St Unit 100Denver, CO 80238-3324
Phone(720) 553-2696
Sole ProprietorNo
Enumeration DateApril 27, 2023
NPPES CertifiedApril 27, 2023
✔ NPI 1740978824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in CO · TL.0009795
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3055 ROSLYN ST UNIT 100, Denver, CO 80238
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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 (PECOS)

Jessica Danielle Wallace Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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. NAOMI ELKA MALAM MD
Family Medicine
3055 ROSLYN ST UNIT 100
DENVER, CO 80238
Denver County (720) 848-0000
HALEH FARR MATINRAD MD
Student in an Organized Health Care Education/Training Program
3055 ROSLYN ST UNIT 100
DENVER, CO 80238
Denver County (720) 553-2696
LILLIAN TOASPERN MD
Student in an Organized Health Care Education/Training Program
3055 ROSLYN ST UNIT 100
DENVER, CO 80238
Denver County (720) 553-2696
ALLISON JACQUELINE COSTELLO MD, MBA
Family Medicine
3055 ROSLYN ST UNIT 100
DENVER, CO 80238
Denver County (720) 848-9000
AARON LESLIE BERGMAN PHD
Psychologist (Clinical)
3055 ROSLYN ST UNIT 100
DENVER, CO 80238
Denver County (720) 848-0000
HANNAH KIMMEL SUPRON MD, MPH
Student in an Organized Health Care Education/Training Program
3055 ROSLYN ST UNIT 100
DENVER, CO 80238
Denver County (720) 553-2696
UNIVERSITY PHYSICIANS INCORPORATED
Family Medicine
3055 ROSLYN ST UNIT 100
DENVER, CO 80238
Denver County (720) 848-9000
DR. BREANNA DANIELLE HOUSS MD
Student in an Organized Health Care Education/Training Program
3055 ROSLYN ST UNIT 100
DENVER, CO 80238
Denver County (303) 697-2583

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 Jessica Wallace's NPI number?

The NPI number for Jessica Wallace is 1740978824. It was assigned to this individual provider in the NPPES registry on April 27, 2023.

Where is Jessica Wallace located?

Jessica Wallace practices at 3055 Roslyn St Unit 100, Denver, CO 80238. The listed phone number is (720) 553-2696.

What is Jessica Wallace's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jessica Wallace enrolled in Medicare?

Yes. Jessica Wallace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jessica Wallace was last updated on April 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.