Ms Jessica Elizabeth Wallace, NURSE PRACTITIONER - Medicare Nurse Practitioner in Manhattan Beach, CA

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Ms Jessica Elizabeth Wallace, NURSE PRACTITIONER is a medicare enrolled "Registered Nurse" in Manhattan Beach, California. She graduated from nursing school in 1997 and has 29 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Martin Luther King Jr Community Medical Foundation, Ucla Radiology Medical Group and her current practice location is 2200 N Sepulveda Blvd, Manhattan Beach, California. You can reach out to her office (for appointments etc.) via phone at (310) 802-0200.

Ms Jessica Elizabeth Wallace is licensed to practice in California (license number 547962) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1215981170.

Contact Information

Ms Jessica Elizabeth Wallace, NURSE PRACTITIONER
2200 N Sepulveda Blvd,
Manhattan Beach, CA 90266-2910
(310) 802-0200
(310) 794-9035

Map and Direction




Provider's Profile

Full NameMs Jessica Elizabeth Wallace
GenderFemale
SpecialityNurse Practitioner
Experience29 Years
Location2200 N Sepulveda Blvd, Manhattan Beach, California
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ms Jessica Elizabeth Wallace graduated from nursing school in 1997
  NPI Data:
  • NPI Number: 1215981170
  • Provider Enumeration Date: 05/22/2006
  • Last Update Date: 12/19/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 7719083500
  • Enrollment ID: I20070511000356

Medical Identifiers

Medical identifiers for Ms Jessica Elizabeth Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1215981170NPI-NPPES
RN547962OtherCAMEDICAL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 547962 (California)Primary
363LF0000XNurse Practitioner - Family 10241 (California)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Martin Luther King, Jr. Community HospitalLos angeles, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Martin Luther King Jr Community Medical Foundation8628359502172
Ucla Radiology Medical Group8921902065179

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. Ms Jessica Elizabeth Wallace allows following entities to bill medicare on her behalf.
Entity NameUcla Radiology Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1881670248
PECOS PAC ID: 8921902065
Enrollment ID: O20031120001026
Entity NameMartin Luther King Jr Community Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356899777
PECOS PAC ID: 8628359502
Enrollment ID: O20170109001311

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. Ms Jessica Elizabeth 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
Ms Jessica Elizabeth Wallace, NURSE PRACTITIONER
5767 W Century Blvd Ste 400,
Los Angeles, CA 90045-5631

Ph: () -		Ms Jessica Elizabeth Wallace, NURSE PRACTITIONER
2200 N Sepulveda Blvd,
Manhattan Beach, CA 90266-2910

Ph: (310) 802-0200

Reviews and Comments


Registered Nurse Nurses in Manhattan Beach, CA

Mrs. Christine Louise Constable, MSN, WHNP-BC
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 1805 Wendy Way, Manhattan Beach, CA 90266
Phone: 310-487-7002    
Jeffrey Marchesani,
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 1601 N Sepulveda Blvd, Ste 216, Manhattan Beach, CA 90266
Phone: 310-393-7654    
Onyekwere Chibueze Anyanwu, PMHNP-BC
Registered Nurse
Medicare: Medicare Enrolled
Practice Location: 1000 N Sepulveda Blvd Ste 270, Manhattan Beach, CA 90266
Phone: 925-282-1778    
Traci Neri, RN BSN IBCLC
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 3405 Pine Ave, Manhattan Beach, CA 90266
Phone: 310-849-3347    
Andrew Litak,
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 216 Rosecrans Ave Apt 4, Manhattan Beach, CA 90266
Phone: 760-217-6959    
Claire Manning,
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 1145 N Poinsettia Ave, Manhattan Beach, CA 90266
Phone: 415-658-1280    

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.