Jennifer Marie Wallace, NURSE PRACTITIONER - Medicare Nurse Practitioner in Deptford, NJ

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Jennifer Marie Wallace, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Gerontology" in Deptford, New Jersey. Her current practice location is 202 Cabot Ct, Deptford, New Jersey. You can reach out to her office (for appointments etc.) via phone at (856) 885-4579.

Jennifer Marie Wallace is licensed to practice in New Jersey (license number 26NJ01341100) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1790412591.

Contact Information

Jennifer Marie Wallace, NURSE PRACTITIONER
202 Cabot Ct,
Deptford, NJ 08096-5114
(856) 885-4579
Not Available

Map and Direction




Provider's Profile

Full NameJennifer Marie Wallace
GenderFemale
SpecialityNurse Practitioner - Gerontology
Location202 Cabot Ct, Deptford, New Jersey
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1790412591
  • Provider Enumeration Date: 08/02/2022
  • Last Update Date: 08/02/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 4789068420
  • Enrollment ID: I20220908001464

Medical Identifiers

Medical identifiers for Jennifer Marie Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1790412591NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LG0600XNurse Practitioner - Gerontology 26NJ01341100 (New Jersey)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. Jennifer Marie Wallace allows following entities to bill medicare on her behalf.
Entity NameSenior Healthcare Outreach Program
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588707954
PECOS PAC ID: 5890893713
Enrollment ID: O20070531000042
Entity NameNurse Practitioner Professional Resources
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558516260
PECOS PAC ID: 1951450931
Enrollment ID: O20090521000466

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. Jennifer Marie 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
Jennifer Marie Wallace, NURSE PRACTITIONER
36 Walker Rd,
West Orange, NJ 07052-4403

Ph: (973) 715-5586		Jennifer Marie Wallace, NURSE PRACTITIONER
202 Cabot Ct,
Deptford, NJ 08096-5114

Ph: (856) 885-4579

Reviews and Comments


Nurse Practitioner Nurses in Deptford, NJ

Ms. Meghan C Salvatore, M.S.N, R.N, B.S
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 849 Cooper St, Deptford, NJ 08096
Phone: 856-848-6346    Fax: 856-848-5734
Eunice Salazar, DNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 13 Kraemer Ct, Deptford, NJ 08096
Phone: 267-467-5367    
Elizabeth Forman, APN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 849 Cooper St, Deptford, NJ 08096
Phone: 856-848-6346    
Mrs. Sharon M. Ceravolo, APN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 849 Cooper St, Deptford, NJ 08096
Phone: 856-848-6346    Fax: 856-848-5734
Robert Austin, APN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 849 Cooper St, Deptford, NJ 08096
Phone: 856-848-6346    Fax: 856-848-5734
Dr. Janea Gibbs, DNP, MBA, AGPCNP-BC
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: Po Box 5253, Deptford, NJ 08096
Phone: 856-288-6109    
Jae Hoon Cha,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 1132 Cooper St, Deptford, NJ 08096
Phone: 856-848-8060    Fax: 856-848-8038

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.