DR. HEATHER A WALLACE (DSC., PA-C) – Physician Assistant, NPI 1821342106
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in VA
Provider Addresses for DR. HEATHER A WALLACE (DSC., PA-C)
620 John Paul Jones Cir
Portsmouth, VA 237082111
Phone: (757) 953-5000
Type: Location
1701 N Senate Blvd
Indianapolis, IN 462021239
Phone: (317) 962-0582
Fax: (317) 962-2082
Type: Location
53 RENAISSANCE WOODS CT
XENIA, OH 453858703
Phone:
Type: Mailing
1701 N SENATE BLVD
INDIANAPOLIS, IN 462021239
Phone: (317) 962-0582
Fax: (317) 962-2082
Type: Location
3259 CATLIN AVE
QUANTICO, VA 221345109
Phone: (703) 784-1630
Type: Mailing
3066 SEARS RD
SUGARCRK TWP, OH 453707726
Phone:
Type: Mailing
915 E 1ST ST
DULUTH, MN 558052107
Phone: (218) 249-6450
Type: Location
104 Union Ave
Syracuse, NY 132031843
Phone: (315) 424-0490
Fax: (315) 475-0916
Type: Location
5486 Indian River Rd
Virginia Beach, VA 234645365
Phone: (757) 424-2490
Type: Location
7101 Jahnke Rd
Richmond, VA 232254017
Phone: (804) 483-0000
Type: Location
301 Prospect Ave
Syracuse, NY 132031807
Phone: (315) 448-5331
Fax: (315) 448-5589
Type: Location
3000 Arlington Ave Ste 2C
Toledo, OH 436142595
Phone: (419) 383-3759
Fax: (419) 383-2962
Type: Location
1100 Goethals Dr Ste E
Richland, WA 993523301
Phone: (509) 942-3095
Fax: (509) 942-3097
Type: Location
33-57 Harrison St
Johnson City, NY 137902107
Phone: (607) 763-6311
Type: Location
NAVAL MEDICAL CENTER PORTSMOUTH
620 JOHN PAUL JONE CIRCLE
PORTSMOUTH, VA 23708
Phone:
Type: Mailing
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 237082111
Phone: (757) 953-5000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $682.
Total Amount is formed as General ($682) + Research ($0) + Ownership ($0) = $682.
Last reported payment date: 2024-10-24 • Largest payer in this snapshot: Inari Medical, Inc. ($204).
Total Amount
$682
General + Research + Ownership
Payments
9
Total payment records
General Amount
$682
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inari Medical, Inc. | $204 |
| W. L. Gore & Associates, Inc. | $168 |
| BIOTISSUE HOLDINGS INC. | $137 |
| LeMaitre Vascular, Inc. | $125 |
| Janssen Biotech, Inc. | $25 |
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: 2025-10-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
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 |
|---|---|---|---|---|
| I20161007001022 | I | Physician Assistant | VA | TBD |
| I20170525001454 | I | Physician Assistant | DC | TBD |
| I20230321000432 | I | Physician Assistant | NY | TBD |
| I20240223003372 | I | Physician Assistant | OH | TBD |
| I20251028002408 | I | Physician Assistant | MN | 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 | 22 | 21 | $0 |
| 35301 | Removal of blood clot and portion of chest, neck, or brain artery | 11 | 11 | $0 |
Insurance plans in this area (ZIP 23708)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NY | |
| Family Practice | NY | |
| Family Practice | NY | |
| Physician Assistant | NY | |
| - | NY | |
| Nurse Practitioner | NY | |
| Cardiovascular Disease (Cardiology) | NY | |
| - | NY | |
| Physician Assistant | FL | |
| Nurse Practitioner | NY |
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