JACK WESLEY WALLIS MD
NPI 1962484733
Family Medicine in San Marcos, TX

Q: What is Jack Wallis's NPI number?

The NPI number for Jack Wallis is 1962484733. It was assigned to this individual provider in the NPPES registry on November 17, 2005.

Q: What is Jack Wallis's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Wallis was last updated on September 14, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 November 17, 2005PECOS EnrolledAccepts Medicare Assignment

2108 HUNTER RD, SUITE 116, SAN MARCOS, TX 78666(512) 754-7700(512) 754-0012 Get Directions Write a Review

NPPES record last updated: September 14, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jack Wesley Wallis Md NPPES

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

JACK WESLEY WALLIS MD (NPI 1962484733) is an individual family medicine provider in San Marcos, Texas, licensed in Texas (G8488) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Christus Santa Rosa Hospital-san Marcos, and is a graduate of Other (1980).

NPPES Registry Identity

NPI1962484733

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJACK WESLEY WALLISCredential: MD

Location Address2108 HUNTER RD, SUITE 116San Marcos, TX 78666-5156

Mailing Address2108 Hunter Rd, Suite 116San Marcos, TX 78666-5156 · (512) 754-7700 · Fax (512) 754-0012

Phone(512) 754-7700

Fax(512) 754-0012

Sole ProprietorYes

Medical School CMSOtherGraduated 1980

Enumeration DateNovember 17, 2005

Last NPPES UpdateSeptember 14, 2010

✔ NPI 1962484733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TX · G8488

Definition

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.

Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X · License G8488 (TX)

2108 HUNTER RD, San Marcos, TX 78666

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Other Identifiers 3

Medicare UPINC23132

Medicaid122902302TX

Medicare ID-Type Unspecified00DK82

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

Jack Wesley Wallis Md 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 ID8628267648

PECOS Enrollment IDI20110106000571

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.

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.

360 services197 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

188 services188 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

173 services108 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

50 services49 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

47 services45 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

46 services44 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Christus Santa Rosa Hospital-San Marcos

Acute Care Hospitals · San Marcos, TX

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number450272

Location1301 Wonder World DriveSan Marcos, TX 78666 · Hays County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78666 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Cushion for use on nasal mask interface, replacement only, each A7032