Jacob Wallace, MD
NPI 1124604061 · Obstetrics & Gynecology Physician · Saint Louis, MO
Enrolled with Medicare as Practitioner - Obstetrics/Gynecology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jacob Wallace, MD is a Obstetrics & Gynecology Physician provider in Saint Louis, MO (NPI 1124604061).
Provider details
- NPI number
- 1124604061
- Entity type
- Individual
- Primary specialty
- Obstetrics & Gynecology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 3 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Oxycodone Hcl | 19 | 19 |
| Ibuprofen | 13 | — |
| Ondansetronbrand: Ondansetron Odt | 11 | 11 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Additional practice locations (1)
- 4352 Manchester AveSaint Louis, MO 63110-2138Phone: (314) 531-5444Fax: (314) 531-0063
Registry dates
- Enumerated
- 2021-03-22
- Last updated
- 2025-07-08
- Certified
- 2025-07-08
Frequently asked questions
- What is Jacob Wallace's NPI number?
- Jacob Wallace's National Provider Identifier (NPI) is 1124604061, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jacob Wallace's specialty?
- Jacob Wallace is listed in the NPPES registry with a primary specialty of Obstetrics & Gynecology Physician (Allopathic & Osteopathic Physicians).
- Where is Jacob Wallace located?
- Jacob Wallace's practice location on file with NPPES is 401 Holly Hills Ave, Saint Louis, MO 63111-2410.
- What is Jacob Wallace's phone number?
- The practice phone number listed in the NPPES registry for Jacob Wallace is (314) 353-5190.
- Does Jacob Wallace accept Medicare?
- Jacob Wallace is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jacob Wallace's NPI active?
- Yes — Jacob Wallace's NPI (1124604061) is active in the NPPES registry as of the last update on 2025-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.