FREDA ELLEN WALL (PA-C) – Surgical Physician Assistant, NPI 1063417608
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
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Provider Addresses for FREDA ELLEN WALL (PA-C)
2001, Peachtree Road Northeast, Brookwood Hills, Atlanta, Georgia, 30309, United States
STE 645
ATLANTA, GA 303091476
Phone: (404) 350-0106
Fax: (404) 350-0176
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 1 Open Payments records for all available years, with a total value of $113.
Total Amount is formed as General ($113) + Research ($0) + Ownership ($0) = $113.
Last reported payment date: 2023-08-23 • Largest payer in this snapshot: Blueprint Medicines Corporation ($113).
Total Amount
$113
General + Research + Ownership
Payments
1
Total payment records
General Amount
$113
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Blueprint Medicines Corporation | $113 |
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: 2004-05-04
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 |
|---|---|---|---|---|
| I20040504000443 | I | Physician Assistant | GA | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 83 | 78 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 72 | 11 | $0 |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 37 | 37 | $0 |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 23 | 21 | $0 |
| 71046 | X-ray of chest, 2 views | 22 | 22 | $0 |
Insurance plans in this area (ZIP 30309)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NJ | |
| Family Practice | GA | |
| Family Practice | GA | |
| Physician Assistant | GA | |
| - | GA | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| Internal Medicine, Emergency Medicine | GA | |
| Physician Assistant | GA | |
| Nurse Practitioner | GA |
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