Mr Jared Lee Wallace, PA-C - Medicare Physician Assistant in Kenai, AK

Mr Jared Lee Wallace, PA-C is a medicare enrolled "Physician Assistant" in Kenai, Alaska. He graduated from nursing school in 2009 and has 15 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Odyssey Family Practice Llc and his current practice location is 43783 Kenai Spur Hwy, Kenai, Alaska. You can reach out to his office (for appointments etc.) via phone at (907) 283-9116.

Mr Jared Lee Wallace is licensed to practice in * (Not Available) (license number ) 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 1063746667.

Contact Information

Mr Jared Lee Wallace, PA-C
43783 Kenai Spur Hwy,
Kenai, AK 99611
(907) 283-9116
(907) 283-9122



Provider's Profile

Full NameMr Jared Lee Wallace
GenderMale
SpecialityPhysician Assistant
Experience15 Years
Location43783 Kenai Spur Hwy, Kenai, Alaska
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:
  • Mr Jared Lee Wallace graduated from nursing school in 2009
  NPI Data:
  • NPI Number: 1063746667
  • Provider Enumeration Date: 09/29/2009
  • Last Update Date: 03/07/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2961543319
  • Enrollment ID: I20100106000812

Medical Identifiers

Medical identifiers for Mr Jared Lee Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063746667NPI-NPPES
1020379MedicaidAK

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant (* (Not Available))Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Central Peninsula General HospitalSoldotna, AKHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Odyssey Family Practice Llc34769890624

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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 Jared Lee 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 Jared Lee Wallace, PA-C
43783 Kenai Spur Hwy,
Kenai, AK 99611-9708

Ph: (907) 283-9116
Mr Jared Lee Wallace, PA-C
43783 Kenai Spur Hwy,
Kenai, AK 99611

Ph: (907) 283-9116

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Physician Assistant Nurses in Kenai, AK

Mark Victor Restad, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 11472 Kenai Spur Hwy, Suite #2, Kenai, AK 99611
Phone: 907-283-6030    Fax: 907-283-3194
Ms. Rene' D. Kenney, RN, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 1611 Tanaga Ave, Kenai, AK 99611
Phone: 907-395-0526    
Jennifer Beacham Person, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 10543 Kenai Spur Hwy, Kenai, AK 99611
Phone: 907-395-0463    
Jason Brett Parry, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 11595 Kenai Spur Hwy, Kenai, AK 99611
Phone: 907-313-4596    
Robert Vernon Mcrorie Jr.,
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 10543 Kenai Spur Hwy, Kenai, AK 99611
Phone: 907-283-9118    

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