Jordan Scott Wallace, MD in Snoqualmie, WA

Jordan Scott Wallace, MD is a medicare enrolled "Pediatrics" physician in Snoqualmie, Washington. His current practice location is 9801 Frontier Ave Se, Snoqualmie, Washington. You can reach out to his office (for appointments etc.) via phone at (425) 831-2300.

Jordan Scott Wallace is licensed to practice in Washington (license number MD61570069) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1780210658.

Contact Information

	Jordan Scott Wallace, MD
	9801 Frontier Ave Se, Snoqualmie, WA 98065-5200
	(425) 831-2300
	Not Available

Map and Direction

Physician's Profile

Full Name	Jordan Scott Wallace
Gender	Male
Speciality	Pediatrics
Location	9801 Frontier Ave Se, Snoqualmie, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1780210658
Provider Enumeration Date: 03/22/2020
Last Update Date: 09/10/2024

Medicare PECOS Information:

PECOS PAC ID: 1951723493
Enrollment ID: I20230825001890

Medical Identifiers

Medical identifiers for Jordan Scott Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780210658	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	A188568 (California)	Secondary
208M00000X	Hospitalist	A188568 (California)	Secondary
208000000X	Pediatrics	MD61570069 (Washington)	Primary

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. Jordan Scott Wallace allows following entities to bill medicare on his behalf.

Entity Name	Stanford Health Care
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437292927 PECOS PAC ID: 6709797491 Enrollment ID: O20031124000348

Entity Name	Lpch Medical Group Div Of Lucile
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1417907940 PECOS PAC ID: 0840298543 Enrollment ID: O20061113000232

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. Jordan Scott 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 Address	Practice Location Address
Jordan Scott Wallace, MD 725 Welch Rd, Palo Alto, CA 94304-1601 Ph: (650) 497-8000	Jordan Scott Wallace, MD 9801 Frontier Ave Se, Snoqualmie, WA 98065-5200 Ph: (425) 831-2300

Reviews and Comments

Pediatrics Doctors in Snoqualmie, WA

Hema Nirmal, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 37624 Se Fury St, Ste 101, Snoqualmie, WA 98065 Phone: 425-888-2016 Fax: 206-320-5170
Dr. Chinonyelum Blessing Obih, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 37624 Se Fury St Ste 101, Snoqualmie, WA 98065 Phone: 425-888-2016 Fax: 206-320-5170
Dr. Penny Russell Tronolone, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: Echo Glen Children's Center, 33010 Se 99th St, Snoqualmie, WA 98065 Phone: 425-831-2501 Fax: 425-831-2545
Dr. Neeta Jain, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 9801 Frontier Ave Se, Snoqualmie, WA 98065 Phone: 425-831-2300 Fax: 425-831-2361

Jordan Scott Wallace, MD - Medicare Pediatrics in Snoqualmie, WA