Jacob Wallace, MD - Medicare Diagnostic Radiology in Wichita, KS

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Jacob Wallace, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Wichita, Kansas. He went to University Of Kansas School Of Med (kc/wich/sal) and graduated in 2015 and has 9 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice United Radiology Billing Llc and his current practice location is 1010 N Kansas St, Wichita, Kansas. You can reach out to his office (for appointments etc.) via phone at (316) 293-2665.

Jacob Wallace is licensed to practice in Kansas (license number 94-08609) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1871974527.

Contact Information

Jacob Wallace, MD
1010 N Kansas St,
Wichita, KS 67214-3124
(316) 293-2665
Not Available

Map and Direction




Physician's Profile

Full NameJacob Wallace
GenderMale
SpecialityDiagnostic Radiology
Experience9 Years
Location1010 N Kansas St, Wichita, Kansas
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jacob Wallace attended and graduated from University Of Kansas School Of Med (kc/wich/sal) in 2015
  NPI Data:
  • NPI Number: 1871974527
  • Provider Enumeration Date: 06/17/2015
  • Last Update Date: 07/05/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 0244544336
  • Enrollment ID: I20210524001019

Medical Identifiers

Medical identifiers for Jacob Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1871974527NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 94-08609 (Kansas)Secondary
2085R0202XRadiology - Diagnostic Radiology 94-08609 (Kansas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Salina Regional Health CenterSalina, KSHospital
Ellsworth County Medical CenterEllsworth, KSHospital
Memorial HospitalAbilene, KSHospital
Rooks County Health CenterPlainville, KSHospital
Clay County Medical CenterClay center, KSHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
United Radiology Billing Llc044654926510

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jacob Wallace allows following entities to bill medicare on his behalf.
Entity NameKansas University Physicians Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003858333
PECOS PAC ID: 8921911587
Enrollment ID: O20040401000328
Entity NameAdvanced General Radiology Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1811394919
PECOS PAC ID: 4183947773
Enrollment ID: O20150107001234
Entity NameUnited Radiology Billing Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205298601
PECOS PAC ID: 0446549265
Enrollment ID: O20160518001752

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacob Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jacob Wallace, MD
1010 N Kansas St,
Wichita, KS 67214-3124

Ph: (316) 293-2665		Jacob Wallace, MD
1010 N Kansas St,
Wichita, KS 67214-3124

Ph: (316) 293-2665

Reviews and Comments


Radiology Doctors in Wichita, KS

Dr. Larry C Graham Ii, MD
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Phone: 316-689-5050    Fax: 316-689-6192
Tim Edward Stone,
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Phone: 316-293-2665    
Dr. Donald C S Tan, MD
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Dr. Joshua Dale Buchtel, MD
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Phone: 316-293-2699    
Elizabeth Perez-elmore, RN BSN
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Mike Lam, DO
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Medicare: Medicare Enrolled
Practice Location: 1010 N Kansas St, Wichita, KS 67214
Phone: 316-293-2635    
Dr. Timothy C Benning, MD
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Medicare: Accepting Medicare Assignments
Practice Location: 3600 E Harry St, Wichita, KS 67218
Phone: 316-689-6173    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.