AMANDA DANIEL WALLACE (PA-C) – Surgical Physician Assistant, NPI 1518249838
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,431 PHYSICIAN ASSISTANT in GA
Provider Addresses for AMANDA DANIEL WALLACE (PA-C)
1270 Friendship Rd
Braselton, GA 305175630
Phone: (678) 207-4477
Fax: (678) 207-4478
Type: Location
1945 Beverly Rd
Gainesville, GA 305012034
Phone: (770) 532-7092
Fax: (770) 536-0383
Type: Location
725 Jesse Jewell Pkwy SE
Gainesville, GA 305013834
Phone: (770) 532-7092
Fax: (770) 536-0383
Type: Location
743 Spring St NE
Gainesville, GA 305013715
Phone: (770) 532-7092
Fax: (770) 536-0383
Type: Location
1400 River Pl
Braselton, GA 305175600
Phone: (770) 532-7092
Fax: (770) 536-0383
Type: Location
1765 Old West Broad St
Athens, GA 306062853
Phone: (706) 549-1663
Fax: (706) 546-8792
Type: Location
835 Austin Dr
Demorest, GA 305354513
Phone: (706) 754-8518
Fax: (706) 754-6238
Type: Location
801 Austin Dr
Demorest, GA 305354513
Phone: (706) 754-8066
Fax: (706) 754-8086
Type: Location
PO BOX 658
GAINESVILLE, GA 305030658
Phone: (770) 718-1122
Fax: (770) 533-4786
Type: Mailing
655 JESSE JEWELL PKWY SE STE B
GAINESVILLE, GA 305013854
Phone: (770) 532-7092
Fax: (770) 536-0383
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 17 Open Payments records for all available years, with a total value of $329.
Total Amount is formed as General ($329) + Research ($0) + Ownership ($0) = $329.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: ViiV Healthcare Company ($144).
Total Amount
$329
General + Research + Ownership
Payments
17
Total payment records
General Amount
$329
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ViiV Healthcare Company | $144 |
| Lilly USA, LLC | $40 |
| MOXIMED, INC | $26 |
| Abbott Laboratories | $25 |
| Spine Wave, Inc. | $24 |
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: 2011-09-27
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 |
|---|---|---|---|---|
| I20110927000391 | 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 |
|---|---|---|---|---|
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 1,104 | 12 | $0 |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 293 | 92 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 228 | 120 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 120 | 90 | $0 |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 109 | 31 | $0 |
Insurance plans in this area (ZIP 30517)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| - | GA | |
| General Surgery | GA | |
| Diagnostic Radiology | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| - | GA | |
| Certified Nurse Midwife (Cnm) | GA |
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