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CHRISTIAN ALEXANDER WALLACE PA-C
NPI 1477201440
Physician Assistant in Milwaukee, WI

Active since March 17, 2022PECOS Enrolled
507 N 17TH STREET, MILWAUKEE, WI 53233(414) 288-5688 Get Directions Write a Review

NPPES record last updated: November 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Christian Alexander Wallace Pa-c NPPES

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

CHRISTIAN ALEXANDER WALLACE PA-C (NPI 1477201440) is an individual physician assistant in Milwaukee, Wisconsin, licensed in Tennessee (5111) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477201440
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameCHRISTIAN ALEXANDER WALLACECredential: PA-C
Location Address507 N 17TH STREETMilwaukee, WI 53233
Mailing Address507 North 17th StreetMilwaukee, WI 53233
Phone(414) 288-5688
Sole ProprietorYes
Enumeration DateMarch 17, 2022
Last NPPES UpdateNovember 21, 2022
NPPES CertifiedNovember 21, 2022
✔ NPI 1477201440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TN · 5111
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
507 N 17TH STREET, Milwaukee, WI 53233
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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 (PECOS)

Christian Alexander Wallace Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 53233 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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 4

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

ARIANNA MOCZYNSKI PA-C
Physician Assistant
507 N 17TH STREET
MILWAUKEE, WI 53233
Milwaukee County (414) 288-5688
ALEFIYAH KHUZEMA ADAM
Student in an Organized Health Care Education/Training Program
507 N 17TH STREET
MILWAUKEE, WI 53233
Milwaukee County (414) 288-5688
REBECCA ANNE LEGRETT
Physician Assistant
507 N 17TH STREET
MILWAUKEE, WI 53233
Milwaukee County (414) 288-0607
JOSHUA R HART
Physician Assistant
507 N 17TH STREET
MILWAUKEE, WI 53233
Milwaukee County (414) 288-5688

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 Christian Wallace's NPI number?

The NPI number for Christian Wallace is 1477201440. It was assigned to this individual provider in the NPPES registry on March 17, 2022.

Where is Christian Wallace located?

Christian Wallace practices at 507 N 17th Street, Milwaukee, WI 53233. The listed phone number is (414) 288-5688.

What is Christian Wallace's specialty?

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

Is Christian Wallace enrolled in Medicare?

Yes. Christian Wallace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Christian Wallace was last updated on November 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.