KRISTINA MARIE WALLACE PA-C
NPI 1417326984
Physician Assistant in Grants Pass, OR

Active since September 15, 2015PECOS EnrolledAccepts Medicare Assignment
537 UNION AVE, SECOND FLOOR, GRANTS PASS, OR 97527(541) 479-6777 Get Directions Write a Review

NPPES record last updated: June 8, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Kristina Marie Wallace Pa-c NPPES

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

KRISTINA MARIE WALLACE PA-C (NPI 1417326984) is an individual physician assistant in Grants Pass, Oregon, licensed in Oregon (PA174747) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS, is affiliated with Sacred Heart Medical Center - Riverbend, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1417326984
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKRISTINA MARIE WALLACECredential: PA-C
Location Address537 UNION AVE, SECOND FLOORGrants Pass, OR 97527-5543
Mailing Address1115 Se 164th Ave Dept 358Vancouver, WA 98683-8004 · (360) 729-1253 · Fax (360) 729-3185
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateSeptember 15, 2015
Last NPPES UpdateJune 8, 2020
NPPES CertifiedJune 8, 2020
NPI 1417326984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in OR · PA174747
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.

537 UNION AVE, Grants Pass, OR 97527

Accepted Insurance

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

Kristina Marie Wallace Pa-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 ID3072823335
PECOS Enrollment IDI20151117001760
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sacred Heart Medical Center - Riverbend

Acute Care Hospitals · Springfield, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380102
Location3333 Riverbend DriveSpringfield, OR 97477 · Lane County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97527 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
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
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 19

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

Internal Medicine
537 UNION AVE, FIRST FLOOR
GRANTS PASS, OR 97527
Physician Assistant
537 UNION AVE, SECOND FLOOR, 2A
GRANTS PASS, OR 97527
Nurse Practitioner (Family)
537 UNION AVE
GRANTS PASS, OR 97527
Urology
537 UNION AVE, SECOND FLOOR 2B
GRANTS PASS, OR 97527
Otolaryngology
537 UNION AVE, SECOND FLOOR -2C
GRANTS PASS, OR 97527
Orthopaedic Surgery
537 UNION AVE, SECOND FLOOR 2A
GRANTS PASS, OR 97527
Surgery
537 UNION AVE
GRANTS PASS, OR 97527
Nurse Practitioner (Family)
537 UNION AVE
GRANTS PASS, OR 97527

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 Kristina Wallace's NPI number?

The NPI number for Kristina Wallace is 1417326984. It was assigned to this individual provider in the NPPES registry on September 15, 2015.

Where is Kristina Wallace located?

Kristina Wallace practices at 537 Union Ave Second Floor, Grants Pass, OR 97527. The listed phone number is (541) 479-6777.

What is Kristina Wallace's specialty?

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

Is Kristina Wallace enrolled in Medicare?

Yes. Kristina 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.

What insurance does Kristina Wallace accept?

Health plans from Kaiser Permanente, Moda Health Plan, Inc. and PacificSource Health Plans list Kristina Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kristina Wallace affiliated with any hospitals?

According to CMS data, Kristina Wallace is affiliated with Sacred Heart Medical Center - Riverbend.

When was this NPI record last updated?

The NPPES record for Kristina Wallace was last updated on June 8, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.