MS. JESSICA DENE WALLACE CNM
NPI 1760100028
Advanced Practice Midwife in Tuba City, AZ

Q: What is Jessica Wallace's NPI number?

The NPI number for Jessica Wallace is 1760100028. It was assigned to this individual provider in the NPPES registry on August 22, 2022.

Q: What is Jessica Wallace's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Wallace was last updated on August 22, 2022. 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.

Active since August 22, 2022PECOS EnrolledAccepts Medicare Assignment

167 NORTH MAIN STREET, TUBA CITY, AZ 86045(928) 283-2501(928) 283-2677 Get Directions Write a Review

NPPES record last updated: August 22, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Ms. Jessica Dene Wallace Cnm NPPES

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

MS. JESSICA DENE WALLACE CNM (NPI 1760100028) is an individual advanced practice midwife in Tuba City, Arizona, licensed in Arizona (CNM278747) and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1760100028

Entity TypeIndividualFemale

Primary Taxonomy367A00000X

Provider Legal NameMS. JESSICA DENE WALLACECredential: CNM

Location Address167 NORTH MAIN STREETTuba City, AZ 86045-0600

Mailing AddressPo Box 600Tuba City, AZ 86045-0600 · (928) 283-2781 · Fax (928) 283-2677

Phone(928) 283-2501

Fax(928) 283-2677

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateAugust 22, 2022

NPPES CertifiedMay 28, 2022

✔ NPI 1760100028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367A00000X

License✔ Licensed in AZ · CNM278747

Definition

Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.

167 NORTH MAIN STREET, Tuba City, AZ 86045

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.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

Ms. Jessica Dene Wallace Cnm 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 ID4688059181

PECOS Enrollment IDI20220920001816

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 86045 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

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.

JIMMIE L TAYLOR RN

Registered Nurse (Ambulatory Care)