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BENJAMIN PANTONE WALLACE PA
NPI 1992936066
Physician Assistant - Surgical in Salt Lake City, UT

Active since August 06, 2009PECOS EnrolledAccepts Medicare Assignment
1160 E 3900 S STE 3500, SALT LAKE CITY, UT 84124(801) 476-6900 Get Directions Write a Review

NPPES record last updated: January 2, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Benjamin Pantone Wallace Pa NPPES

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

BENJAMIN PANTONE WALLACE PA (NPI 1992936066) is an individual surgical provider in Salt Lake City, Utah and active in the NPI registry since August 2009. He is enrolled in Medicare PECOS, is affiliated with Mckay-dee Hospital, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1992936066
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameBENJAMIN PANTONE WALLACECredential: PA
Location Address1160 E 3900 S STE 3500Salt Lake City, UT 84124-1264
Mailing AddressPo Box 281490Atlanta, GA 30384-1490
Phone(801) 476-6900
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateAugust 6, 2009
Last NPPES UpdateJanuary 2, 2026
NPPES CertifiedJanuary 2, 2026
✔ NPI 1992936066 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
1160 E 3900 S STE 3500, Salt Lake City, UT 84124
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.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

Benjamin Pantone Wallace Pa 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 ID648318113
PECOS Enrollment IDI20140925002302
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.

Hospital Affiliations CMS Care Compare 2

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

Mckay-Dee Hospital

Acute Care Hospitals · Ogden, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460004
Location4401 Harrison BoulevardOgden, UT 84403 · Weber County
Emergency services Birthing friendly

St Mark's Hospital

Acute Care Hospitals · Salt Lake City, UT
3/5 CMS rating
OwnershipProprietary
CMS Certification Number460047
Location1200 East 3900 SouthSalt Lake City, UT 84124 · Salt Lake County
Emergency services Birthing friendly

Referred Medical Equipment & Supplies CMS DME claims 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
5 suppliers14 claims14 services$18.04 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
5 suppliers14 claims14 services$92.18 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

GABRIEL DAN FRAMPTON PA-C
Physician Assistant (Surgical)
1160 E 3900 S STE 3500
SALT LAKE CITY, UT 84124
Salt Lake County (801) 743-4750
KELSEY SLUGOCKI PA-C
Physician Assistant
1160 E 3900 S STE 3500
SALT LAKE CITY, UT 84124
Salt Lake County (801) 476-6900
DR. RAFE C CONNORS MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1160 E 3900 S STE 3500
SALT LAKE CITY, UT 84124
Salt Lake County (801) 476-6900
BRIANA CIVELLO ACNP
Nurse Practitioner
1160 E 3900 S STE 3500
SALT LAKE CITY, UT 84124
Salt Lake County (801) 743-4750

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 Benjamin Wallace's NPI number?

The NPI number for Benjamin Wallace is 1992936066. It was assigned to this individual provider in the NPPES registry on August 6, 2009.

Where is Benjamin Wallace located?

Benjamin Wallace practices at 1160 E 3900 S Ste 3500, Salt Lake City, UT 84124. The listed phone number is (801) 476-6900.

What is Benjamin Wallace's specialty?

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

Is Benjamin Wallace enrolled in Medicare?

Yes. Benjamin 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 Benjamin Wallace accept?

Health plans from Select Health list Benjamin 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 Benjamin Wallace affiliated with any hospitals?

According to CMS data, Benjamin Wallace is affiliated with Mckay-Dee Hospital and St Mark's Hospital.

When was this NPI record last updated?

The NPPES record for Benjamin Wallace was last updated on January 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.