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ASHLYN WALLACE FNP-C
NPI 1104640887
Nurse Practitioner - Family in Fairfax, VA

Active since November 11, 2024PECOS EnrolledAccepts Medicare Assignment
8613 ROUTE 29 STE 200N, FAIRFAX, VA 22031(571) 350-8400(703) 280-9596 Get Directions Write a Review

NPPES record last updated: November 11, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 11, 2025, Nov 11, 2024 (2 updates tracked since 2024).

About Ashlyn Wallace Fnp-c NPPES

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

ASHLYN WALLACE FNP-C (NPI 1104640887) is an individual family provider in Fairfax, Virginia, licensed in Virginia (0024191724) and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS and is a graduate of Georgetown University School Of Medicine (2024).

NPPES Registry Identity

NPI1104640887
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameASHLYN WALLACECredential: FNP-C
Location Address8613 ROUTE 29 STE 200NFairfax, VA 22031-2171
Mailing Address3040 Williams Dr Ste 100Fairfax, VA 22031-4618 · (571) 350-8400 · Fax (703) 280-9596
Phone(571) 350-8400
Fax(703) 280-9596
Sole ProprietorNo
Medical School CMSGeorgetown University School Of MedicineGraduated 2024
Enumeration DateNovember 11, 2024
Last NPPES UpdateNovember 11, 20252 updates tracked since enumeration
NPPES CertifiedNovember 11, 2025
✔ NPI 1104640887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in VA · 0024191724
8613 ROUTE 29 STE 200N, Fairfax, VA 22031
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ashlyn Wallace Fnp-c 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 ID1658807086
PECOS Enrollment IDI20241210000073, I20250428003290
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.

Medicare Billing Reassignment

Medicare enrollment records show Ashlyn Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Virginia Cancer Specialists, P.C.
Same address
Hematology & Oncology
8613 LEE HWY # 200N
Fairfax, VA 22031
  • Reassigned Medicare billing, District of Columbia and Virginia enrollments
  • 78 clinicians in this Medicare group
NPI 1346294519 (703) 280-5390

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22031 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
Most-billed visit code 99214
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 5

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

SARA ELIZABETH MCKAY PA-C
Physician Assistant (Surgical)
8613 ROUTE 29 STE 200N
FAIRFAX, VA 22031
Fairfax County (571) 350-8400
DR. JESSICA SUTHERLAND HEINTZ MD
Internal Medicine (Hospice and Palliative Medicine)
8613 ROUTE 29 STE 200N
FAIRFAX, VA 22031
Fairfax County (571) 350-8400
DR. STEPHANIE R AKBARI MD
Surgery
8613 ROUTE 29 STE 200N
FAIRFAX, VA 22031
Fairfax County (703) 208-3120
MARICHU BERRO NICHOLS FAMILY NURSE PRACTIT
Nurse Practitioner (Family)
8613 ROUTE 29 STE 200N
FAIRFAX, VA 22031
Fairfax County (571) 350-8400
MISS ALEXANDRIA JOZY FLAHERTY PA-C
Physician Assistant (Surgical)
8613 ROUTE 29 STE 200N
FAIRFAX, VA 22031
Fairfax County (571) 350-8400

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 Ashlyn Wallace's NPI number?

The NPI number for Ashlyn Wallace is 1104640887. It was assigned to this individual provider in the NPPES registry on November 11, 2024.

Where is Ashlyn Wallace located?

Ashlyn Wallace practices at 8613 Route 29 Ste 200N, Fairfax, VA 22031. The listed phone number is (571) 350-8400.

What is Ashlyn Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Ashlyn Wallace enrolled in Medicare?

Yes. Ashlyn 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.

Which organization bills Medicare for Ashlyn Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ashlyn Wallace reassigns Medicare benefits to Virginia Cancer Specialists, P.C. (Fairfax, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ashlyn Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ashlyn Wallace was last updated on November 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.