JENNIFER M WALLACE PA-C
NPI 1972791747
Physician Assistant - Surgical in St Petersburg, FL

Q: What is Jennifer Wallace's NPI number?

The NPI number for Jennifer Wallace is 1972791747. It was assigned to this individual provider in the NPPES registry on October 5, 2007.

Q: What is Jennifer Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Wallace was last updated on March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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 October 05, 2007PECOS EnrolledAccepts Medicare Assignment

620 10TH ST N STE 1D, ST PETERSBURG, FL 33705(727) 828-8400(727) 333-6435 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 14, 2025, Sep 7, 2024 (2 updates tracked since 2024).

On this page

About Jennifer M Wallace Pa-c NPPES

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

JENNIFER M WALLACE PA-C (NPI 1972791747) is an individual surgical provider in St Petersburg, Florida, licensed in Florida (PA9104356) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS, is affiliated with St Anthonys Hospital, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1972791747

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameJENNIFER M WALLACECredential: PA-C

Location Address620 10TH ST N STE 1DSt Petersburg, FL 33705-1407

Mailing Address2995 Drew St Fl 2Clearwater, FL 33759-3012 · (727) 315-7496

Phone(727) 828-8400

Fax(727) 333-6435

Sole ProprietorYes

Medical School CMSOtherGraduated 2007

Enumeration DateOctober 5, 2007

Last NPPES UpdateMarch 14, 20252 updates tracked since enumeration

NPPES CertifiedMarch 14, 2025

✔ NPI 1972791747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in FL · PA9104356

620 10TH ST N STE 1D, St Petersburg, FL 33705

Open in Google Maps ↗

Other Identifiers 1

Medicaid292900700FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, 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

Jennifer M Wallace Pa-c 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 ID5496844250

PECOS Enrollment IDI20071130000405

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

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.

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

18 services12 patients

Hospital Affiliations CMS Care Compare 2

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

St Anthonys Hospital

Acute Care Hospitals · Saint Petersburg, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number100067

Location1200 Seventh Ave NSaint Petersburg, FL 33705 · Pinellas County

Emergency services

Morton Plant Hospital

Acute Care Hospitals · Clearwater, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100127

Location300 Pinellas StClearwater, FL 33756 · Pinellas County

Emergency services Birthing friendly

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.

Reported Quality Measures

Perioperative Care: Selection of Prophylactic Antibiotic - First OR Second Generation Cephalosporin

Percentage of surgical patients aged 18 years and older undergoing procedures with the indications for a first OR second generation cephalosporin prophylactic antibiotic, who had an order for a first OR second generation cephalosporin for antimicrobial…

100%33 patients

Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients)

Percentage of surgical patients aged 18 years and older undergoing procedures for which venous thromboembolism (VTE) prophylaxis is indicated in all patients, who had an order for Low Molecular Weight Heparin (LMWH), Low- Dose Unfractionated Heparin (LDUH)…

100%33 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LARRY L ERTEL M.D.

Pediatrics

620 10TH ST N STE 1D
SAINT PETERSBURG, FL 33705

Pinellas County (727) 824-7161

CEDRIC D. SHORTER M.D.

Neurological Surgery

620 10TH ST N STE 1D
ST PETERSBURG, FL 33705

Pinellas County (727) 828-8400

KIRK W JOBE M.D.

Neurological Surgery

620 10TH ST N STE 1D
SAINT PETERSBURG, FL 33705

Pinellas County (727) 828-8400

BAYCARE MEDICAL GROUP, INC

Orthopaedic Surgery

620 10TH ST N STE 1D
ST PETERSBURG, FL 33705

Pinellas County (727) 724-7136

ADAM ROSS BEFELER M.D.

Neurological Surgery

620 10TH ST N STE 1D
ST PETERSBURG, FL 33705

Pinellas County (727) 828-8400

MOHAMED FIKRY PA-C

Physician Assistant (Surgical)

620 10TH ST N STE 1D
ST PETERSBURG, FL 33705

Pinellas County (727) 828-8400

MR. SIMBAD PUCURICA NP

Nurse Practitioner (Family)

620 10TH ST N STE 1D
SAINT PETERSBURG, FL 33705

Pinellas County (727) 828-8400

BAYCARE MEDICAL GROUP INC

Family Medicine

620 10TH ST N STE 1D
ST PETERSBURG, FL 33705

Pinellas County (727) 824-7161

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 1972791747. It was assigned to this individual provider in the NPPES registry on October 5, 2007.

Where is Jennifer Wallace located?

Jennifer Wallace practices at 620 10th St N Ste 1D, St Petersburg, FL 33705. The listed phone number is (727) 828-8400.

What is Jennifer Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Jennifer Wallace enrolled in Medicare?

Yes. Jennifer 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 Jennifer Wallace accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Oscar Health Maintenance Organization of Florida and 1 other insurer 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.

Is Jennifer Wallace affiliated with any hospitals?

According to CMS data, Jennifer Wallace is affiliated with St Anthonys Hospital and Morton Plant Hospital.

When was this NPI record last updated?

The NPPES record for Jennifer Wallace was last updated on March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.