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BROOKE MELANIE WALLACE PA
NPI 1083504740
Physician Assistant in Henderson, NV

Active since July 05, 2025PECOS EnrolledAccepts Medicare Assignment
1348 PASEO VERDE PKWY STE 100, HENDERSON, NV 89012(702) 847-6252(702) 847-6254 Get Directions Write a Review

NPPES record last updated: April 23, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 23, 2026, Apr 6, 2026, Jul 5, 2025 (3 updates tracked since 2025).

About Brooke Melanie Wallace Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOKE MELANIE WALLACE PA (NPI 1083504740) is an individual physician assistant in Henderson, Nevada and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1083504740
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameBROOKE MELANIE WALLACECredential: PA
Location Address1348 PASEO VERDE PKWY STE 100Henderson, NV 89012-5723
Mailing Address1348 Paseo Verde Pkwy Ste 100Henderson, NV 89012-5723 · (702) 847-6252 · Fax (702) 847-6254
Phone(702) 847-6252
Fax(702) 847-6254
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateJuly 5, 2025
Last NPPES UpdateApril 23, 20263 updates tracked since enumeration
NPPES CertifiedApril 23, 2026
✔ NPI 1083504740 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1348 PASEO VERDE PKWY STE 100, Henderson, NV 89012
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brooke Melanie Wallace Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002319951
PECOS Enrollment IDI20250915002668
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89012 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$71.14 typical visit price
range $18.27 – $140.96
Typical copayment $17.78 (range $4.56 – $35.24)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEVADA HEALTH TANITA PLLC
Obstetrics & Gynecology
1348 PASEO VERDE PKWY STE 100
HENDERSON, NV 89012
Clark County (702) 847-6252
AMY MONRREAL PA-C
Physician Assistant (Medical)
1348 PASEO VERDE PKWY STE 100
HENDERSON, NV 89012
Clark County (702) 847-6252
GABRIELA N. PENA MD
Obstetrics & Gynecology
1348 PASEO VERDE PKWY STE 100
HENDERSON, NV 89012
Clark County (702) 847-6252
CODY MURRAY PA-C
Physician Assistant
1348 PASEO VERDE PKWY STE 100
HENDERSON, NV 89012
Clark County (702) 847-6252
DR. FELIX EDWARD HERNANDEZ III D.O.
Obstetrics & Gynecology
1348 PASEO VERDE PKWY STE 100
HENDERSON, NV 89012
Clark County (702) 847-6252
AMANDA LEE TILLETT MD
Obstetrics & Gynecology
1348 PASEO VERDE PKWY STE 100
HENDERSON, NV 89012
Clark County (702) 847-6252
DR. DOUGLAS TANITA M.D.
Obstetrics & Gynecology
1348 PASEO VERDE PKWY STE 100
HENDERSON, NV 89012
Clark County (702) 847-6252

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brooke Wallace's NPI number?

The NPI number for Brooke Wallace is 1083504740. It was assigned to this individual provider in the NPPES registry on July 5, 2025.

Where is Brooke Wallace located?

Brooke Wallace practices at 1348 Paseo Verde Pkwy Ste 100, Henderson, NV 89012. The listed phone number is (702) 847-6252.

What is Brooke Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Brooke Wallace enrolled in Medicare?

Yes. Brooke Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Brooke Wallace was last updated on April 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.