TRACEY WALL (PA-C) – Physician Assistant, NPI 1306038492
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,166 PHYSICIAN ASSISTANT in CO
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Provider Addresses for TRACEY WALL (PA-C)
The Memorial Hospital – Medical Clinic, 785, Russell Street, Craig, Moffat County, Colorado, 81625, United States
CRAIG, CO 816252019
Phone: (970) 826-2300
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $33.
Total Amount is formed as General ($33) + Research ($0) + Ownership ($0) = $33.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Indivior Inc. ($33).
Total Amount
$33
General + Research + Ownership
Payments
2
Total payment records
General Amount
$33
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Indivior Inc. | $33 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-12-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20071227000537 | I | Physician Assistant | CO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 75 | 12 | $0 |
Insurance plans in this area (ZIP 81625)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CO | |
| Physician Assistant | CO | |
| Physician Assistant | CO | |
| Physician Assistant | IA | |
| Physician Assistant | CO | |
| Nurse Practitioner | CO | |
| Emergency Medicine | AZ | |
| Nurse Practitioner | NM | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | CO |
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