Mr John David Wallace, PA-C - Medicare Physician Assistant in East Jordan, MI

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Mr John David Wallace, PA-C is a medicare enrolled "Physician Assistant" in East Jordan, Michigan. His current practice location is 601 Bridge St, East Jordan, Michigan. You can reach out to his office (for appointments etc.) via phone at (231) 536-2206.

Mr John David Wallace is licensed to practice in Michigan (license number 5601006422) 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 1487909511.

Contact Information

Mr John David Wallace, PA-C
601 Bridge St,
East Jordan, MI 49727-9383
(231) 536-2206
(231) 536-7150

Map and Direction




Provider's Profile

Full NameMr John David Wallace
GenderMale
SpecialityPhysician Assistant
Location601 Bridge St, East Jordan, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1487909511
  • Provider Enumeration Date: 07/15/2012
  • Last Update Date: 09/20/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 8628227089
  • Enrollment ID: I20121001000251

Medical Identifiers

Medical identifiers for Mr John David Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1487909511NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 5601006422 (Michigan)Primary

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. Mr John David 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
Mr John David Wallace, PA-C
601 Bridge St,
East Jordan, MI 49727-9383

Ph: (231) 536-2206		Mr John David Wallace, PA-C
601 Bridge St,
East Jordan, MI 49727-9383

Ph: (231) 536-2206

Reviews and Comments


Physician Assistant Nurses in East Jordan, MI

Mr. Samuel G Dyste, P.A.
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 601 Bridge St, East Jordan, MI 49727
Phone: 231-536-2206    Fax: 231-536-9864

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.